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General NPI Number Information
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NPI Number | 1831602838
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Entity Type | Organization
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Legal Business Name | SACRED SPACE MIDWIFERY & HOLISTIC HEALTH
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 85 CONTINENTAL DR
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City | RENO
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State | NV
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Zip | 89509-3432
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Country | US
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Telephone | 775-338-0755
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Fax |
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Provider Business Mailing Address
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Address Line | 85 CONTINENTAL DR
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City | RENO
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State | NV
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Zip | 89509-3432
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Country | US
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Telephone | 775-338-0755
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Fax |
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Authorized Official
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Title or Position | OWNER, PRIMARY MIDWIFE
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Name | MS. TIFFANY HOFFMAN
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Credential | MS, LM, CPM
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Telephone | 775-338-0755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | LM484
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License Number State | CA
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