Provider Demographics
NPI:1164831681
Name:SCHIFFMAN, IAN
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:SCHIFFMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3881 W BETH PARK DR
Mailing Address - Street 2:
Mailing Address - City:WEST VALLEY
Mailing Address - State:UT
Mailing Address - Zip Code:84120-3385
Mailing Address - Country:US
Mailing Address - Phone:801-787-1019
Mailing Address - Fax:
Practice Address - Street 1:3881 W BETH PARK DR
Practice Address - Street 2:
Practice Address - City:WEST VALLEY
Practice Address - State:UT
Practice Address - Zip Code:84120-3385
Practice Address - Country:US
Practice Address - Phone:801-787-1019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical