Individual
TIFFANY DAWN HOLTHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5404 SW LEE BLVD, LAWTON, OK 73505-9695
(580) 355-5242
(580) 355-5245
Mailing address
PO BOX 2309, LAWTON, OK 73502-2309
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5288
OK
104100000X
Social Worker
6345
KS
Other
Enumeration date
06/25/2007
Last updated
04/28/2016
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