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TIFFANY NICHOLE AGBO
Mental Health >> Counselor >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1518284132
Individual Registrant: TIFFANY NICHOLE AGBO
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1900 E LA PALMA AVE #101 ANAHEIM, CA 92805-1647 US
Tel: 714-399-3480 Fax: 714-399-3481
Tel: 714-399-3480 Fax: 714-399-3481
Contact information for business:
1900 E LA PALMA AVE #101 ANAHEIM, CA 92805-1647 US
Tel: 714-399-3480 Fax: 714-399-3481
Tel: 714-399-3480 Fax: 714-399-3481
Registration Information:
NPI: 1518284132
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 101YM0800X | Behavioral Health & Social Service Providers Counselor Mental Health |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
