Individual
TIFFANY SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
6490 S MCCARRAN BLVD, F52, RENO, NV 89509-6165
(775) 400-8876
Mailing address
6490 S MCCARRAN BLVD, F52, RENO, NV 89509-6165
(775) 400-8876
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NVMT.7343
NV
Other
Enumeration date
06/29/2015
Last updated
06/29/2015
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