Individual
TIFFANY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 W 6TH AVE, GARY, IN 46402-1711
(219) 885-4264
Mailing address
1166 NEW JERSEY ST, GARY, IN 46403-3581
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
03/25/2019
Last updated
03/25/2019
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