Organization
DR. TIFFANY ZACHERY, LLC
Active
Other names
Dr. Tiffany Zachery, LCSW
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIFFANY SHARELL ZACHERY LCSW (OWNER)
(337) 290-9868
Entity
Organization
Contact information
Practice address
110 TRAVIS STREET, SUITE 113, LAFAYETTE, LA 70503-2452
(225) 614-2757
Mailing address
PO BOX 62506, LAFAYETTE, LA 70596-2506
(337) 290-9868
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11337
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1033690102
MEDICARE
LA
05
—
1033690102
—
LA
Enumeration date
01/14/2019
Last updated
01/14/2019
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