Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | NV |
NPI | 1003183716 |
---|---|
Provider Name | Tiffany Crossley |
First Address | Henderson, NV 89014-3982 |
Second Address | North Las Vegas, NV 89030-3967 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2011 |
Last Update Date | 23/11/2011 |