Forrest, Tiffany Blake

Forrest, Tiffany Blake is an individual health care provider with primary practice located at 30 Ardisia Ln , Saint Johns FL 32259-3881. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Forrest, Tiffany Blake can be contacted via phone (904) 376-3800.

Contact Information

Primary practice address
30 Ardisia Ln Saint Johns FL 32259-3881
Phone: (904) 376-3800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-17-45567 Florida
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH22337 Florida

Profile Details

NPI number 1639684681
LBN Legal business name Forrest, Tiffany Blake
Credentials MS
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2017
Last updated Sep 12th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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