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NPI Code Detail

MEDICARE: TIFFANY LANGEVIN

MEDICARE: TIFFANY LANGEVIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1093164485
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY LANGEVIN
Provider Business Mailing Address
First Line : 3755 W LAKE MEAD BLVD
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89032-4897
Country : US
Telephone Number : 702-487-5665
Fax Number :
Provider Business Practice Location Address
First Line : 3755 W LAKE MEAD BLVD
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89032-4897
Country : US
Telephone Number : 702-487-5665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2016
Last Update Date : 06/07/2016

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Directions to “ TIFFANY LANGEVIN ” Practice Location

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