| NPI | 1669727137 |
|---|---|
| Former Name | TIFFANY POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TX AP131281) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 914084) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2023-04-18 |