NPI | 1003513375 |
---|---|
Former Name | MARY E BELSOM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: TX 37981) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 67230) |
Enumeration Date | 2023-02-07 |
Last Update Date | 2023-09-27 |