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NPI Code Detail

MEDICARE: TIFFANY GALLEGO LCSW

MEDICARE:   TIFFANY  GALLEGO  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLCSW-18246AZ

General Provider Information

NPI Number : 1144967712
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY GALLEGO LCSW
Provider Business Mailing Address
First Line : 6107 E GRANT RD
Second Line :
City : TUCSON
State : AZ
Zip : 85712-5828
Country : US
Telephone Number : 520-722-9631
Fax Number :
Provider Business Practice Location Address
First Line : 6107 E GRANT RD
Second Line :
City : TUCSON
State : AZ
Zip : 85712-5828
Country : US
Telephone Number : 520-722-9631
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2022
Last Update Date : 05/16/2022

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Directions to “ TIFFANY GALLEGO LCSW” Practice Location

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