| 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 |