| NPI | 1255463485 |
|---|---|
| Former Name | THERESA LYNN PICKUP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: TX 202126) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NV MFT0678) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2013-10-30 |