| NPI | 1104601509 |
|---|---|
| Former Name | TIFFANY ELIZABETH LAHUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: CA 95166691) |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2023-08-25 |