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1336402171
TIFFANY L. ICKES
PORTLAND, IN
NPI
1336402171
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-06-18
Last Update Date
2012-06-18
Business Address
-- TIFFANY L. ICKES MHC
931 W WATER ST
PORTLAND, IN 47371-1755
Phone number: 765-288-1928
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Mailing Address
-- TIFFANY L. ICKES MHC
240 N TILLOTSON AVE
MUNCIE, IN 47304-3988
Phone number: 765-288-1928
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