Provider Demographics
NPI:1588047831
Name:LASH, TIFFANIE DEBORAH
Entity type:Individual
Prefix:
First Name:TIFFANIE
Middle Name:DEBORAH
Last Name:LASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4664 S RUESS RD
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9269
Mailing Address - Country:US
Mailing Address - Phone:989-494-2245
Mailing Address - Fax:
Practice Address - Street 1:4664 S RUESS RD
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9269
Practice Address - Country:US
Practice Address - Phone:989-494-2245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health