MEDICARE: TIFFANY ANN GARZA

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1700743986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIFFANY ANN GARZA

Provider Business Mailing Address
First Line	:	1438 MAIN ST APT 5
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53403-1959
Country	:	US
Telephone Number	:	262-822-7108
Fax Number	:

Provider Business Practice Location Address
First Line	:	5801 WASHINGTON AVE STE 200
Second Line	:
City	:	MOUNT PLEASANT
State	:	WI
Zip	:	53406-4057
Country	:	US
Telephone Number	:	262-864-1141
Fax Number	:

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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