| NPI | 1003351354 |
|---|---|
| Former Name | TIFFANY DANIELLE SHANHOLTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: VA 0133000902) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: MD LBA291) |
| Enumeration Date | 2016-12-22 |
| Last Update Date | 2021-10-20 |