NPI | 1679716575 |
---|---|
Former Name | TIFFANY S GRIVAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11912) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2009-04-08 |
Last Update Date | 2023-01-12 |