NPI | 1619073509 |
---|---|
Former Name | TIFFANY RENEE WILLIAMS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 125562) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 5314) |
1041C0700X Social Worker, Clinical (Licence: NC C006792) | |
Enumeration Date | 2006-09-16 |
Last Update Date | 2022-10-11 |