NPI | 1427326057 |
---|---|
Former Name | TIFFANY KINGSFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007587) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA APC002758) |
Enumeration Date | 2011-12-10 |
Last Update Date | 2014-10-01 |