| NPI | 1154899516 |
|---|---|
| Former Name | TIFFANY WAWOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2018-11-04 |
| Last Update Date | 2018-11-04 |