| NPI | 1144783994 |
|---|---|
| Former Name | TIFFANY PETROVITS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 17944) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ 17944) |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2024-01-04 |