| NPI | 1689294597 |
|---|---|
| Former Name | TIFFANY JACQUELINE MANDL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 8129) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00697900) |
| 101YP2500X Counselor, Professional (Licence: SC 10783) | |
| 101YP2500X Counselor, Professional (Licence: GA LPC015076) | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2025-08-12 |