Individual
TIFFANY STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PEER SUPPORT
Contact information
Practice address
2205 N IRONWOOD PL STE 100, COEUR D ALENE, ID 83814-2487
(208) 415-0299
(804) 807-3799
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 415-0299
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
ID
175T00000X
Peer Specialist
—
—
Other
Enumeration date
05/28/2019
Last updated
12/23/2020
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