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General NPI Number Information
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NPI Number | 1932251667
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Entity Type | Individual
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Provider Name | TIFFANY JILL HEITHOFF PLMHP
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Gender | Female
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7130 S 29TH ST STE A
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City | LINCOLN
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State | NE
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Zip | 68516-5841
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Country | US
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Telephone | 402-420-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 3111 N 70TH ST #6
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City | LINCOLN
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State | NE
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Zip | 68507-2195
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Country | US
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Telephone | 402-440-6769
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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 | 7722
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License Number State | NE
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