| NPI | 1639764988 |
|---|---|
| Former Name | TIFFANY VANLOAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2022-10-12 |