Individual
TIFFANY CHAVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22 MARLINK, LOS LUNAS, NM 87031-5848
(505) 865-1750
Mailing address
22 MARLINK, LOS LUNAS, NM 87031-5848
(505) 865-1750
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
C-6920
NM
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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