Provider Demographics
NPI:1528945680
Name:STINSON, TIFFANY ROSE
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ROSE
Last Name:STINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ROSE
Other - Last Name:WOOLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:813 TROY ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1852
Mailing Address - Country:US
Mailing Address - Phone:937-982-1500
Mailing Address - Fax:937-682-1600
Practice Address - Street 1:813 TROY ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1852
Practice Address - Country:US
Practice Address - Phone:937-982-1500
Practice Address - Fax:937-682-1600
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health