NPI 1104642487

Tiffany Lajara, WAVERPROVIDER

Practitioner Case Manager/Care Coordinator Bridgeport, CT

Practice location

Address: 92 Lewis St, Bridgeport, CT 06605-1224
Phone: (475) 999-4284

Registered specialties

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X Licence 228588899 (CT)

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Registry record

NPI: 1104642487
Entity type: Individual
Sex (as registered): Female
NPI issued: 2 Dec 2024
Record last updated: 2 Dec 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.