Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor |
NPI | 1003312406 |
---|---|
Provider Name | Tiffanni Starling |
First Address | Greensboro, NC 27417-7264 |
Second Address | Greensboro, NC 27405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2018 |
Last Update Date | 26/11/2019 |