Individual
TIFFANY R TSCHANTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
6401 S 16TH ST, PHOENIX, AZ 85042-4417
(623) 337-3114
Mailing address
6401 S 16TH ST, PHOENIX, AZ 85042-4417
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
12772
AZ
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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