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NPI Code Detail

MEDICARE: MRS. TIFFANY M. SHANOWER LISW

MEDICARE: MRS. TIFFANY M. SHANOWER LISW
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
11041C0700XClinical Social WorkerI.0800355OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184746695
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TIFFANY M. SHANOWER LISW
Provider Business Mailing Address
First Line : 2645 HOWENSTINE DR SE
Second Line :
City : EAST SPARTA
State : OH
Zip : 44626-9595
Country : US
Telephone Number : 330-936-9303
Fax Number :
Provider Business Practice Location Address
First Line : 130 W 3RD ST
Second Line :
City : DOVER
State : OH
Zip : 44622-2934
Country : US
Telephone Number : 330-343-6600
Fax Number : 330-343-6405
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2007
Last Update Date : 06/12/2024

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