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1699964585
TIFFANY RENEE' ELLIS
SOUTH LAKE TAHOE, CA
NPI
1699964585
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-10-17
Last Update Date
2007-10-17
Business Address
Ms. TIFFANY RENEE' ELLIS
1120 3RD ST
SOUTH LAKE TAHOE, CA 96150-3451
Phone number: 530-573-3386
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Mailing Address
Ms. TIFFANY RENEE' ELLIS
1120 3RD ST
SOUTH LAKE TAHOE, CA 96150-3451
Phone number: 530-573-3386
Copy
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