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Individual
TIFFANY ROSE CERQUA
Active
Individual
TIFFANY ROSE CERQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.140219
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCDCII.161455
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCDCIII.162057
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0273885
—
OH
Enumeration date
08/05/2014
Last updated
11/12/2024
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