Provider Demographics
NPI:1447707898
Name:CAGLE-GUTHRIE, TIFFANY (RPSGT, RST, CCSH)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:CAGLE-GUTHRIE
Suffix:
Gender:F
Credentials:RPSGT, RST, CCSH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38444 N JOANN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN TAN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85140-4027
Mailing Address - Country:US
Mailing Address - Phone:480-290-8229
Mailing Address - Fax:480-393-7353
Practice Address - Street 1:38444 N JOANN WAY
Practice Address - Street 2:
Practice Address - City:SAN TAN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85140-4027
Practice Address - Country:US
Practice Address - Phone:480-290-8229
Practice Address - Fax:480-393-7353
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
13378247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other