| NPI | 1255966636 |
|---|---|
| Former Name | TIFFANY ST JOHN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 9044) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2024-07-17 |