Individual
TIFFANI PESTOTNIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
847 PARKCENTRE WAY, SUITE #4, NAMPA, ID 83651-1792
(208) 467-2673
(208) 467-4150
Mailing address
847 PARKCENTRE WAY, SUITE #4, NAMPA, ID 83651-1792
(208) 467-2673
(208) 467-4150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
35881
ID
Other
Enumeration date
10/11/2012
Last updated
07/25/2016
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