Individual
TIFFANI RAE HOTWAGNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
1639 N ALPINE RD, ROCKFORD, IL 61107-1449
(815) 484-3143
Mailing address
6614 LANTERNE DR, LOVES PARK, IL 61111-3526
(630) 701-5249
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
03/29/2024
Last updated
04/03/2024
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