Individual
TIFFANY MARY RENAE PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
96 W BUFFALO ST, WARSAW, NY 14569-1210
(585) 219-3654
Mailing address
96 W BUFFALO ST, WARSAW, NY 14569-1210
(585) 219-3654
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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