NPI | 1346575388 |
---|---|
Former Name | TIFFANY LYNAE BYLSMA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 32610) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-10-08 |
Last Update Date | 2012-03-15 |