Individual
TIFFANIE CRUZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWA
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
8211 EBERLE LOOP UNIT B, FORT CAMPBELL, KY 42223-2647
(916) 307-1894
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
P017495
NC
Other
Enumeration date
01/29/2024
Last updated
12/30/2024
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