Individual ProviderTiffany A OntiverosCounselorBehavioral Health & Social Service ProvidersPractice Address121 S Martin Luther King Blvd Ste 200, Las Vegas, NV 89106-4309(702) 486-5004PECOS EnrollmentBased on the most recent information from CMS, provider Tiffany A Ontiveros does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1790067213Provider TypeIndividualFull NameOntiveros, Tiffany ACredentialM.S.GenderFemaleSole ProprietorYesEnumeration Date9/10/2011Last Updated9/19/2012Contact InformationPractice LocationPractice Address121 S Martin Luther King Blvd Ste 200, Las Vegas, NV 89106-4309Phone(702) 486-5004FaxUnlisted FaxMailing LocationMailing Address121 S Martin Luther King Blvd Ste 200, Las Vegas, NV 89106-4309Phone(702) 486-5004FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer