NPI | 1912373960 |
---|---|
Former Name | TIFFANY ISHOLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 4935) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: LA MFT1170) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2024-03-25 |