Provider Demographics
NPI:1992039671
Name:STIFTER, TIFFANY BAXTER (MA, MFT)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:BAXTER
Last Name:STIFTER
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 DOE RUN CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-2706
Mailing Address - Country:US
Mailing Address - Phone:702-498-1981
Mailing Address - Fax:
Practice Address - Street 1:5795 S SANDHILL RD STE G
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-2558
Practice Address - Country:US
Practice Address - Phone:702-498-1981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-28
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01192106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist