Provider Demographics
NPI:1427441047
Name:PIERCE, TIFFANY MICHELLE (MS)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MICHELLE
Last Name:PIERCE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:LEMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8080 E CENTRAL AVE STE 320
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2389
Mailing Address - Country:US
Mailing Address - Phone:316-927-3010
Mailing Address - Fax:316-777-6707
Practice Address - Street 1:1223 N ROCK RD
Practice Address - Street 2:BLDG. G, SUITE 100
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-1269
Practice Address - Country:US
Practice Address - Phone:316-636-8222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2646106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist