Provider Demographics
NPI:1912146879
Name:HUGHES-TROUTMAN, TIFFINY MONIQUE (PHD)
Entity type:Individual
Prefix:
First Name:TIFFINY
Middle Name:MONIQUE
Last Name:HUGHES-TROUTMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-3527
Mailing Address - Country:US
Mailing Address - Phone:678-216-0247
Mailing Address - Fax:
Practice Address - Street 1:123 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-3527
Practice Address - Country:US
Practice Address - Phone:678-216-0247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-16
Last Update Date:2009-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002615103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling