Provider Demographics
NPI:1295977908
Name:GRIDER, TIFFANY K (MS, LGC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:K
Last Name:GRIDER
Suffix:
Gender:F
Credentials:MS, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-8405
Mailing Address - Fax:319-356-7009
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:11196P PFP
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1007
Practice Address - Country:US
Practice Address - Phone:319-353-7242
Practice Address - Fax:319-384-7055
Is Sole Proprietor?:No
Enumeration Date:2009-03-26
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAGC-0034OtherIOWA BOARD OF MEDICINE