NPI | 1285394379 |
---|---|
Former Name | TIFFANY M BOMBARDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 100628) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 115200) |
Enumeration Date | 2021-12-30 |
Last Update Date | 2025-08-04 |