| NPI | 1487991261 |
|---|---|
| Former Name | TIFFANI LEDEL EDMUNDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY22864) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY22864) |
| Enumeration Date | 2013-01-13 |
| Last Update Date | 2017-07-12 |