NPI | 1679086490 |
---|---|
Former Name | TIPHANY BOYD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.161866) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.161978) |
Enumeration Date | 2017-11-15 |
Last Update Date | 2023-11-21 |