| NPI | 1245590363 |
|---|---|
| Former Name | TIFFANY JEWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60460259) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC60202028) |
| 101YP2500X Counselor, Professional (Licence: MD LC6706) | |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2020-04-23 |