| NPI | 1700026176 |
|---|---|
| Former Name | TIFFANY NIERDIECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 61531) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 61531) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2012-09-27 |