| NPI | 1932682283 |
|---|---|
| Former Name | TIFFANI ANN PULLYBLANK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW111949) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 90075) |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2023-06-29 |