Individual
MRS. TIFFANY MARIE SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9153 W 133RD ST, OVERLAND PARK, KS 66213-4333
(913) 257-5185
Mailing address
10405 W 77TH ST APT 108, OVERLAND PARK, KS 66214-1223
(773) 406-4011
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-14-00309
—
Other
Enumeration date
06/26/2018
Last updated
08/20/2019
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