NPI | 1811630361 |
---|---|
Former Name | TIFFANY DAWN ALMASRI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 24-03-11057) |
Additional Taxonomies | 175T00000X Peer Specialist (Licence: OR THW000106154) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 24-CRM-II-0221) | |
Enumeration Date | 2022-04-13 |
Last Update Date | 2024-03-20 |