Individual
MISS TANISHA STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11418 SE 90TH AVE APT 120, HAPPY VALLEY, OR 97086-2606
(330) 687-1464
Mailing address
11418 SE 90TH AVE APT 120, HAPPY VALLEY, OR 97086-2606
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
374J00000X
Doula
Primary
—
OR
Other
Enumeration date
09/06/2017
Last updated
04/11/2023
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