Individual
TIFFANY AMBER LOUGHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35514 INDIGO DR, STERLING HEIGHTS, MI 48310-4946
(586) 212-2671
Mailing address
35514 INDIGO DR, STERLING HEIGHTS, MI 48310-4946
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
63296
MI
Other
Enumeration date
06/02/2014
Last updated
06/02/2014
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