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Individual

TIFFANY ROSE MENZEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
926 SQUARE DANCE LN, FOUNTAIN, CO 80817-4160
(325) 338-6182
Mailing address
926 SQUARE DANCE LN, FOUNTAIN, CO 80817-4160

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-14-16922

Other

Enumeration date
01/06/2015
Last updated
01/21/2015
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