Most Relevant Information
Provider Data
| NPI Number: | 1003388968 |
| Provider Name: | TIFFANI RICCHELE MCKNIGHT |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: | M8449 |
Most Important Dates
| Enumeration Date: | 12/17/2018 |
| Last Updated: | 12/17/2018 |
Provider Practice Location
3502 W NORTHSIDE DR
JACKSON
MS
392134454
Practice Location Phone/Fax
| Phone: | 6013625321 |
| Fax: |
Provider Mailing Location
3502 W NORTHSIDE DR
JACKSON
MS
392134454
Provider Mailing Phone/Fax
| Phone: | 6013625321 |
| Fax: |