NPI | 1528258829 |
---|---|
Former Name | MERCEDES MARSHALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: UT 2501) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 0955) |
Enumeration Date | 2007-08-01 |
Last Update Date | 2012-12-17 |