Individual
TIFFANY GAUMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
625 W WASHINGTON AVE, MADISON, WI 53703-2637
(608) 280-2700
Mailing address
1414 HOOKER AVE, MADISON, WI 53704-3814
(608) 217-8916
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5496-125
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15913-131
WI
Other
Enumeration date
02/20/2012
Last updated
05/22/2015
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