Provider Demographics
NPI:1578908166
Name:ANDERSON, TIFFANY SIOBHAN (PSYD, BCBA)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:SIOBHAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PSYD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 N POINT PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4725
Mailing Address - Country:US
Mailing Address - Phone:770-727-0244
Mailing Address - Fax:770-727-0134
Practice Address - Street 1:3225 N POINT PKWY STE 201
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4725
Practice Address - Country:US
Practice Address - Phone:770-727-0244
Practice Address - Fax:770-727-0134
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-08
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004716101YM0800X, 103TC0700X
1-20-46254103K00000X
103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent