Individual
TIFFANY RENEE SMITH-LAGERBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 ROANOKE AVE, PORTSMOUTH, VA 23704-6333
(757) 575-4456
Mailing address
2701 ROANOKE AVE, PORTSMOUTH, VA 23704-6333
(757) 575-4456
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710102525
VA
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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