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General NPI Number Information
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NPI Number | 1982058202
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Entity Type | Individual
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Provider Name | TIFFANY SPEARS
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Gender | Female
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 02/13/2025
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Provider Practice Location Address
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Address Line | 4285 N RANCHO DR
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City | LAS VEGAS
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State | NV
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Zip | 89130-3446
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Country | US
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Telephone | 702-685-3459
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Fax | 702-851-8528
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Provider Business Mailing Address
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Address Line | 4285 N RANCHO DR
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City | LAS VEGAS
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State | NV
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Zip | 89130-3446
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Country | US
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Telephone | 702-685-3459
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Fax | 702-851-8528
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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