| NPI | 1427134378 |
|---|---|
| Former Name | TIFFANY MARIE BLEEKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 74138) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2022-05-03 |