| Tiffany Holland, Llc | |
|
80 Ladys Island Dr Beaufort SC 29907-1643 | |
| (843) 476-7421 | |
| Not Available |
| Full Name | Tiffany Holland, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 80 Ladys Island Dr, Beaufort, South Carolina |
| Authorized Official Name and Position | Kimberlt Davis (CREDENTIALING SPECIALISTS) |
| Authorized Official Contact | 9124843879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tiffany Holland, Llc Po Box 846 Saint Helena Island SC 29920-0846 Ph: (843) 476-7421 | Tiffany Holland, Llc 80 Ladys Island Dr Beaufort SC 29907-1643 Ph: (843) 476-7421 |
| NPI Number | 1588018543 |
|---|---|
| Provider Enumeration Date | 04/15/2016 |
| Last Update Date | 04/15/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588018543 | NPI | - | NPPES |
| PC1361 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5480 (South Carolina) | Primary |
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