Provider Demographics
NPI:1831602838
Name:SACRED SPACE MIDWIFERY & HOLISTIC HEALTH
Entity type:Organization
Organization Name:SACRED SPACE MIDWIFERY & HOLISTIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRIMARY MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LM, CPM
Authorized Official - Phone:775-338-0755
Mailing Address - Street 1:85 CONTINENTAL DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3432
Mailing Address - Country:US
Mailing Address - Phone:775-338-0755
Mailing Address - Fax:
Practice Address - Street 1:85 CONTINENTAL DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3432
Practice Address - Country:US
Practice Address - Phone:775-338-0755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-13
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM484176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty