| Tifini A. Roberts, Psy.d., Llc | |
|
2146 W Chesterfield Blvd Ste. E202 Springfield MO 65807-8650 | |
| (417) 886-8540 | |
| (417) 886-8560 |
| Full Name | Tifini A. Roberts, Psy.d., Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2146 W Chesterfield Blvd, Springfield, Missouri |
| Authorized Official Name and Position | Tifini Autumn Roberts (PSYCHOLOGIST) |
| Authorized Official Contact | 4178868540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tifini A. Roberts, Psy.d., Llc 2146 W Chesterfield Blvd Ste. E202 Springfield MO 65807-8650 Ph: (417) 886-8540 | Tifini A. Roberts, Psy.d., Llc 2146 W Chesterfield Blvd Ste. E202 Springfield MO 65807-8650 Ph: (417) 886-8540 |
| NPI Number | 1992976955 |
|---|---|
| Provider Enumeration Date | 03/18/2008 |
| Last Update Date | 02/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992976955 | NPI | - | NPPES |
| 497543900 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2007015271 (Missouri) | Primary |
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