NPI | 1518053602 |
---|---|
Former Name | DARLENE DOROTHEA MAYO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 13092) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 5412) |
163W00000X Registered Nurse (Licence: TX 447244) | |
Enumeration Date | 2006-10-05 |
Last Update Date | 2016-02-09 |