NPI | 1831643097 |
---|---|
Former Name | TIFFANY DEVOY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-19125) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178011399) |
106H00000X Marriage & Family Therapist (Licence: IL 208000434) | |
Enumeration Date | 2016-08-05 |
Last Update Date | 2020-07-17 |