| NPI | 1417059635 |
|---|---|
| Former Name | MARY JILL CARPENTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 18330) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MS 1500) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2010-09-30 |