| NPI | 1356884357 |
|---|---|
| Former Name | TIFFANY LEIGH GEARHART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0704011433) |
| Additional Taxonomies | 247000000X Technician, Health Information |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2022-09-09 |