Individual
TIFFANY BLACKHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HBCE, CD
Contact information
Practice address
1525 MESA VERDE DR E STE 210, COSTA MESA, CA 92626-5219
(702) 205-6073
Mailing address
5751 S PEARL ST, LAS VEGAS, NV 89120-2509
(702) 205-6073
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
4570
CA
Other
Enumeration date
07/15/2025
Last updated
07/15/2025
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