Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 225400000X | NV |
NPI | 1730431115 |
---|---|
Provider Name | Tiffany T Alston |
First Address | Las Vegas, NV 89128-0503 |
Second Address | Las Vegas, NV 89128-0503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2012 |
Last Update Date | 09/10/2012 |