| NPI | 1083080139 |
|---|---|
| Former Name | TIFFANY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0014041) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2022-12-09 |