Individual
TIFFANY BROOKE WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 DANA CT, GLASGOW, KY 42141-8753
(270) 576-3736
Mailing address
3621 MARION LN, LAS CRUCES, NM 88012-7579
(050) 592-9620
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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