NPI | 1114336179 |
---|---|
Former Name | TERESA LYNN COLLINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 32697) |
Additional Taxonomies | 103T00000X Psychologist (Licence: UT 4954704-2501) |
Enumeration Date | 2014-08-04 |
Last Update Date | 2016-12-05 |