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1891014320
TIFFANY BAILLY-RENNER
COEUR D ALENE, ID
NPI
1891014320
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Former Name
TIFFANY BAILLY
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X
(Licence: ID 30167)
Enumeration Date
2010-05-24
Last Update Date
2010-05-24
Business Address
-- TIFFANY BAILLY-RENNER LMSW
1200 W IRONWOOD DR
COEUR D ALENE, ID 83814-2660
Phone number: 208-664-9729
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Mailing Address
-- TIFFANY BAILLY-RENNER LMSW
4736 E DEER RD
HARRISON, ID 83833-7894
Phone number:
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