NPI | 1548489172 |
---|---|
Former Name | TIFFANY MCKINNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2001896-SUPV) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.2001896-SUPV) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2024-01-31 |