| Dr. Tiffany Zachery, Llc | |
|
110 Travis Street Suite 113 Lafayette LA 70503-2452 | |
| (225) 614-2757 | |
| Not Available |
| Full Name | Dr. Tiffany Zachery, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 110 Travis Street, Lafayette, Louisiana |
| Authorized Official Name and Position | Tiffany Sharell Zachery (OWNER) |
| Authorized Official Contact | 3372909868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Tiffany Zachery, Llc Po Box 62506 Lafayette LA 70596-2506 Ph: (337) 290-9868 | Dr. Tiffany Zachery, Llc 110 Travis Street Suite 113 Lafayette LA 70503-2452 Ph: (225) 614-2757 |
| NPI Number | 1619441565 |
|---|---|
| Provider Enumeration Date | 01/14/2019 |
| Last Update Date | 01/14/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619441565 | NPI | - | NPPES |
| 1033690102 | Medicaid | LA | |
| 1033690102 | Other | LA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 11337 (Louisiana) | Primary |
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