| NPI | 1346694528 |
|---|---|
| Former Name | TIFFANY JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: OH S.2613955) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCII.161792) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2026-05-29 |