Most Relevant Information
Provider Data
| NPI Number: | 1003197781 |
| Provider Name: | TIFFANY JOANN BERRY |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/08/2011 |
| Last Updated: | 09/02/2014 |
Provider Practice Location
713 NW 138TH ST
EDMOND
OK
730131908
Practice Location Phone/Fax
| Phone: | 4058199599 |
| Fax: |
Provider Mailing Location
713 NW 138TH ST
EDMOND
OK
730131908
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |