| NPI | 1003150301 |
|---|---|
| Former Name | GLENDA LIA BRAVO OTERO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: PR 6619) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: PR 10466) |
| Enumeration Date | 2012-11-27 |
| Last Update Date | 2020-09-22 |