Individual
TIFFANY LANGEVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3755 W LAKE MEAD BLVD, N LAS VEGAS, NV 89032-4897
(702) 487-5665
Mailing address
3755 W LAKE MEAD BLVD, N LAS VEGAS, NV 89032-4897
(702) 487-5665
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437384229
—
NV
Enumeration date
06/07/2016
Last updated
06/07/2016
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