Most Relevant Information
Provider Data
| NPI Number: | 1003063090 |
| Provider Name: | TIFFANY MARIE PRATHER PSYD |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: | 13162-132 |
Most Important Dates
| Enumeration Date: | 08/21/2008 |
| Last Updated: | 08/21/2008 |
Provider Practice Location
10045 W LISBON AVE
WAUWATOSA
WI
532222446
Practice Location Phone/Fax
| Phone: | 4143587999 |
| Fax: | 4143587158 |
Provider Mailing Location
10045 W LISBON AVE
WAUWATOSA
WI
532222446
Provider Mailing Phone/Fax
| Phone: | 4143587999 |
| Fax: | 4143587158 |