| NPI | 1508943234 |
|---|---|
| Former Name | TISHA BIRMINGHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4390) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 4862) |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-04 |