Provider Demographics
NPI:1548685613
Name:HUSEIN, TIFFANY NICOLE (PHD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:NICOLE
Last Name:HUSEIN
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 1:721 N PINES RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-5225
Mailing Address - Country:US
Mailing Address - Phone:509-426-3845
Mailing Address - Fax:509-922-7947
Practice Address - Street 1:721 N PINES RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-5225
Practice Address - Country:US
Practice Address - Phone:509-426-3845
Practice Address - Fax:509-922-7947
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60196500103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist