Provider Demographics
NPI:1225915580
Name:BARNETT, TIFFANY X I
Entity type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:X
Last Name:BARNETT
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3046 S 47TH DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7435
Mailing Address - Country:US
Mailing Address - Phone:928-615-2667
Mailing Address - Fax:
Practice Address - Street 1:15166 N COTTEN LANE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85388-8538
Practice Address - Country:US
Practice Address - Phone:928-615-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician