| NPI | 1538777420 |
|---|---|
| Former Name | TIARRA MCKINNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: IL 180015204) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IL 178015821) |
| Enumeration Date | 2020-07-16 |
| Last Update Date | 2024-04-16 |