| NPI | 1225374937 |
|---|---|
| Former Name | TIFFANYE TEAGARDEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401013040) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401013040) |
| 106H00000X Marriage & Family Therapist (Licence: MI 4101006543) | |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2020-09-18 |