| NPI | 1124263637 |
|---|---|
| Former Name | TIFFANY RAE HORNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 121870) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 215303) |
| 1041C0700X Social Worker Clinical (Licence: MA 000121870) | |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2019-10-28 |