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General NPI Number Information
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NPI Number | 1659023687
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Entity Type | Individual
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Provider Name | MICHELLE TIGUE PHD
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Gender | Female
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 02/17/2026
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Provider Practice Location Address
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Address Line | 133 MAIN AVE W STE 600
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City | TWIN FALLS
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State | ID
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Zip | 83301-6580
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Country | US
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Telephone | 208-825-3730
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Fax | 208-825-3731
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Provider Business Mailing Address
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Address Line | 4030 MOUNTAIN VISTA LN
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City | FILER
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State | ID
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Zip | 83328-5555
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Country | US
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Telephone | 208-404-6049
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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 | 103TH0004X
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Taxonomy Name | Health Psychologist
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License Number |
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License Number State |
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