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Individual

TIFFANY HAYNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW

Contact information

Practice address
1675 CURLEW DR, AMMON, ID 83406-4850
(208) 523-5319
(208) 523-5319
Mailing address
PO BOX 2106, IDAHO FALLS, ID 83403-2106
(208) 523-5319
(208) 523-5627

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-41703
ID
1041C0700X
Clinical Social Worker
LMSW-38327
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1396176582
ID
05
1619134277
ID
Enumeration date
02/05/2019
Last updated
08/15/2025
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