| NPI | 1568740348 |
|---|---|
| Former Name | TIFFANY DAWN POULIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CP00004297) |
| 101YM0800X Counselor Mental Health (Licence: CG60204032) | |
| Enumeration Date | 2011-07-28 |
| Last Update Date | 2022-11-01 |