Tiffany L. Ickes, MHC

NPI #1336402171 in Portland, Indiana

Provider Information

NPI Number: 1336402171
Entity Type: Individual
Name: Tiffany L. Ickes, MHC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: MHC
Enumeration Date: Jun 18, 2012
Last Updated: Jun 18, 2012

Practice Location

Address: 931 W WATER ST
City: Portland
State: Indiana
ZIP Code: 47371-1755
Phone: (765) 288-1928

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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