| NPI | 1154570976 |
|---|---|
| Former Name | TIFFANY LYNN PETERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: AZ 7074) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ TSLP5980) |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2018-04-17 |