Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 4072 | NC |
NPI | 1043588239 |
---|---|
Provider Name | Dr. Tiffany Nicole Gatling |
First Address | Garner, NC 27529-6208 |
Second Address | Fayetteville, NC 28301-3856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2011 |
Last Update Date | 11/04/2016 |