| NPI | 1801440664 |
|---|---|
| Former Name | TAMMY WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2016004560) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 1780143950) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2022-01-14 |