Individual
TIFFANY WANGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LACTATION CONSULTANT
Contact information
Practice address
22653 E DESERT SPOON DR, QUEEN CREEK, AZ 85142-8545
(602) 621-7864
Mailing address
22653 E DESERT SPOON DR, QUEEN CREEK, AZ 85142-8545
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
10/17/2021
Last updated
11/02/2021
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