TIFFANY DIANE BLANTON

GARDENA, CA
NPI1639450711
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: CA  88912)
Additional Taxonomies101YM0800X Counselor, Mental Health
Enumeration Date2011-09-02
Last Update Date2021-12-03
Business Address
TIFFANY DIANE BLANTON LCSW
108 W VICTORIA ST
GARDENA, CA 90248-3523
Phone number: 310-715-2020
Mailing Address
TIFFANY DIANE BLANTON LCSW
108 W VICTORIA ST
GARDENA, CA 90248-3523
Phone number: 310-715-2020