| NPI | 1760122691 |
|---|---|
| Former Name | TIFFANY S. HENRIQUES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 567260) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405029) |
| Enumeration Date | 2022-03-30 |
| Last Update Date | 2023-06-23 |