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General NPI Number Information
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NPI Number | 1720597958
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Entity Type | Individual
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Provider Name | TIFFANY RENEE MIHELISH MS/CC, LPC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2017
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1061B CAMINO CARALAMPI
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City | RIO RICO
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State | AZ
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Zip | 85648-1682
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Country | US
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Telephone | 520-415-0203
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 162
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City | NOGALES
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State | AZ
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Zip | 85628-0162
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Country | US
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Telephone | 520-461-8465
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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 | LPC-16530
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License Number State | AZ
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