Individual
TIFFANY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33 PEACH ROSE LN, GENOA, WV 25517-7598
(304) 654-8907
Mailing address
89 PEACH ROSE LN, GENOA, WV 25517-7598
(304) 654-8907
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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