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NPI Code Detail

MEDICARE: TIFFANY GARGANO

MEDICARE:   TIFFANY  GARGANO
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1346689643
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY GARGANO
Provider Business Mailing Address
First Line : 1230 BRIDGE ST STE 1
Second Line :
City : LOWELL
State : MA
Zip : 01850-1261
Country : US
Telephone Number : 978-455-3397
Fax Number :
Provider Business Practice Location Address
First Line : 1230 BRIDGE ST STE 1
Second Line :
City : LOWELL
State : MA
Zip : 01850-1261
Country : US
Telephone Number : 978-455-3397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2013
Last Update Date : 06/13/2022

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Directions to “ TIFFANY GARGANO ” Practice Location

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