| NPI | 1245604461 |
|---|---|
| Former Name | TYSHANN MINGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 102L00000X Psychoanalyst |
| Enumeration Date | 2015-11-26 |
| Last Update Date | 2018-05-03 |