| NPI | 1043315849 |
|---|---|
| Former Name | MARTHA L CORRELL DUBOSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 13842) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: TX 13842) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2023-12-29 |