Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CA |
NPI | 1003131046 |
---|---|
Provider Name | Tiffany I Meyers |
First Address | Fresno, CA 93711-1562 |
Second Address | Fresno, CA 93710-7620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 01/04/2010 |