Provider Demographics
NPI:1730362989
Name:JESTER, TIFFANY N (NCC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:N
Last Name:JESTER
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:N
Other - Last Name:TOMASKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 MONT BLANC BLVD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-7615
Mailing Address - Country:US
Mailing Address - Phone:302-678-3020
Mailing Address - Fax:
Practice Address - Street 1:103 MONT BLANC BLVD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-7615
Practice Address - Country:US
Practice Address - Phone:302-678-3020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE0000596101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional