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General NPI Number Information
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NPI Number | 1003702044
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Entity Type | Individual
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Provider Name | TIFFANY WAAHILA
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Gender | Female
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 98 E LAKE MEAD PKWY
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City | HENDERSON
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State | NV
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Zip | 89015-5540
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Country | US
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Telephone | 702-433-3038
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Fax |
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Provider Business Mailing Address
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Address Line | 98 E LAKE MEAD PKWY STE 301
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City | HENDERSON
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State | NV
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Zip | 89015-6444
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Country | US
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Telephone | 808-896-1318
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CI5549
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License Number State | NV
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