NPI | 1134490477 |
---|---|
Other Name | SCOTT TIFFANY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC5257) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 10-R-31) |
101YP2500X Counselor, Professional (Licence: OR C2797) | |
Enumeration Date | 2012-01-18 |
Last Update Date | 2020-12-01 |