NPI | 1770846859 |
---|---|
Former Name | TIFFANIE RAINEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: AR 13-01EI) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR 12-11AE-PL) |
Enumeration Date | 2012-06-22 |
Last Update Date | 2019-06-17 |