NPI | 1720348097 |
---|---|
Former Name | TIFFANY JEAN BILLINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LPC-4758) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC-4758) |
101YM0800X Counselor, Mental Health (Licence: ID LPC-4758) | |
101YS0200X Counselor, School (Licence: ID LPC-4758) | |
Enumeration Date | 2012-05-21 |
Last Update Date | 2012-05-21 |