NPI | 1225301328 |
---|---|
Former Name | DEDRA DEANN LEMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 34952) |
Additional Taxonomies | 103TS0200X Psychologist, School |
Enumeration Date | 2012-02-20 |
Last Update Date | 2025-05-13 |