| NPI | 1710539051 |
|---|---|
| Former Name | TIFFANY GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: OH 398381) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OH CNP.0029275) |
| Enumeration Date | 2019-07-16 |
| Last Update Date | 2021-09-16 |