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General NPI Number Information
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NPI Number | 1215398987
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Entity Type | Individual
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Provider Name | TIFFANY LYNN HOGUE LPC
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Gender | Female
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Dates
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Enumeration Date | 03/09/2016
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 545 CHEYENNE DR STE G
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City | EVANSTON
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State | WY
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Zip | 82930-5323
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Country | US
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Telephone | 307-363-2705
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Fax |
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Provider Business Mailing Address
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Address Line | 142 APACHE DR
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City | EVANSTON
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State | WY
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Zip | 82930-4522
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Country | US
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Telephone | 307-677-5287
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PPC-943
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-1701
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License Number State | WY
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