MEDICARE: MS. TIFFANY ANN ORYEM

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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1548695893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TIFFANY ANN ORYEM

Provider Business Mailing Address
First Line	:	304 S JONES BLVD # 3724
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	616-287-0693
Fax Number	:

Provider Business Practice Location Address
First Line	:	304 S JONES BLVD # 3724
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89107-2623
Country	:	US
Telephone Number	:	616-287-0693
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2013
Last Update Date	:	07/12/2024

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