Provider Demographics
NPI:1881144954
Name:RUZIEV, TIFFANY (LMHCA)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:RUZIEV
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:GREY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:100 N HOWARD ST STE W
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0508
Mailing Address - Country:US
Mailing Address - Phone:204-693-8337
Mailing Address - Fax:
Practice Address - Street 1:2250 MCGREGOR BLVD
Practice Address - Street 2:APARTMENT 1413
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901
Practice Address - Country:US
Practice Address - Phone:719-522-3655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WAMC61480608101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health