NPI | 1073623021 |
---|---|
Former Name | JOLETA BALES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: TX 1338) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 1507-041965) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2007-07-08 |