Individual
TIFFANY A JANISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2501 SHELBY RD, LA CROSSE, WI 54601-8037
(608) 788-5700
Mailing address
PO BOX 45, BANGOR, WI 54614-0045
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1710-027
WI
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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