Provider Information for 1215398987
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TIFFANY LYNN HOGUE LPC
Sex: Female
NPI: 1215398987
Last Updated: 2021-08-16
Certification Date: 2021-08-16
Certification Date: 2021-08-16
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1215398987 | ||||||||||||
| Enumeration Date | 2016-03-09 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 142 APACHE DR EVANSTON, WY 82930-4522 United States Phone: 307-677-5287 | Fax: | ||||||||||||
| Primary Practice Address | 545 CHEYENNE DR STE G EVANSTON, WY 82930-5323 United States Phone: 307-363-2705 | Fax: | ||||||||||||
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