| NPI | 1417344045 |
|---|---|
| Former Name | MARY JO CHAVEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM CMH0179271) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0173551) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2020-07-02 |