NPI | 1689069346 |
---|---|
Former Name | TIFFANY MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14968) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH13253) |
Enumeration Date | 2015-03-31 |
Last Update Date | 2021-06-24 |