Individual
TIFFANY ELAINE COGSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSS, FSS, QMHA II
Contact information
Practice address
627 NE EVANS ST, MCMINNVILLE, OR 97128-3923
(503) 434-7523
Mailing address
PO BOX 278, AMITY, OR 97101-0278
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/23/2017
Last updated
05/22/2023
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