Provider Demographics
NPI:1447065180
Name:VOLLMAR, TIFFANI AMBER
Entity type:Individual
Prefix:
First Name:TIFFANI
Middle Name:AMBER
Last Name:VOLLMAR
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 1:107 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:GREEN SPRINGS
Mailing Address - State:OH
Mailing Address - Zip Code:44836-9645
Mailing Address - Country:US
Mailing Address - Phone:419-967-0667
Mailing Address - Fax:
Practice Address - Street 1:107 MAPLE LN
Practice Address - Street 2:
Practice Address - City:GREEN SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:44836-9645
Practice Address - Country:US
Practice Address - Phone:419-967-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH373H00000X251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services