| NPI | 1346673084 |
|---|---|
| Former Name | MARTHA JANE BRAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: CO PSY0003901) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NC 1097) |
| Enumeration Date | 2013-08-16 |
| Last Update Date | 2013-08-16 |