| NPI | 1649519281 |
|---|---|
| Former Name | TIFFANY ANN BLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: TX 116075) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: FL OT15599) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2014-04-08 |