Provider Demographics
NPI:1376872119
Name:FINATERI, TIFFANY A (LMSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:FINATERI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 N ALLUMBAUGH ST
Mailing Address - Street 2:STE. 102
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-9212
Mailing Address - Country:US
Mailing Address - Phone:208-287-0993
Mailing Address - Fax:208-287-0996
Practice Address - Street 1:413 N ALLUMBAUGH ST
Practice Address - Street 2:STE. 102
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-9212
Practice Address - Country:US
Practice Address - Phone:208-287-0993
Practice Address - Fax:208-287-0996
Is Sole Proprietor?:No
Enumeration Date:2009-12-07
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-29793104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker