NPI | 1447418975 |
---|---|
Former Name | TIFFANY GILLIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: PA PS017663) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PA PS017663) |
Enumeration Date | 2008-05-30 |
Last Update Date | 2024-04-03 |