Provider Demographics
NPI:1316224280
Name:MANGAY-AYAM, TIFFANEE (NCTM)
Entity Type:Individual
Prefix:
First Name:TIFFANEE
Middle Name:
Last Name:MANGAY-AYAM
Suffix:
Gender:F
Credentials:NCTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44682 MORLEY DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48036-1358
Mailing Address - Country:US
Mailing Address - Phone:586-421-4062
Mailing Address - Fax:586-421-4072
Practice Address - Street 1:44682 MORLEY DR
Practice Address - Street 2:
Practice Address - City:CLINTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48036-1358
Practice Address - Country:US
Practice Address - Phone:586-421-4062
Practice Address - Fax:586-421-4072
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist