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Individual

TIFFANY PHILLIPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1951 STELLA LAKE ST STE 36, LAS VEGAS, NV 89106-2144
(702) 595-8309
Mailing address
1951 STELLA LAKE ST STE 36, LAS VEGAS, NV 89106-2144
(702) 595-8309

Taxonomy

Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A6246638
DRIVER LICENSE
NV
Enumeration date
12/17/2021
Last updated
12/17/2021
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