| NPI | 1285614123 |
|---|---|
| Former Name | CHARLOTTE LYNN MUNGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 8678) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 000366000359) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2007-07-08 |