NPI | 1821168295 |
---|---|
Former Name | TIFFANY DAWN WEILNAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NC 2380LPA) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: NC 2380LPA) |
103TC2200X Psychologist, Clinical Child & Adolescent (Licence: NC 2380LPA) | |
Enumeration Date | 2006-11-09 |
Last Update Date | 2007-07-08 |