NPI | 1093523516 |
---|---|
Former Name | BAILEY JO GOMEZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 204186) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 204186) |
Enumeration Date | 2024-12-30 |
Last Update Date | 2024-12-30 |