Provider Demographics
NPI:1639959638
Name:D'AMBROSIO-DAY, TIFFANY PARKER
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:PARKER
Last Name:D'AMBROSIO-DAY
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 1:910 E MISSOULA AVE
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-4023
Mailing Address - Country:US
Mailing Address - Phone:443-966-0732
Mailing Address - Fax:
Practice Address - Street 1:714 STONERIDGE DR STE 1
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7046
Practice Address - Country:US
Practice Address - Phone:406-418-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health