| NPI | 1588753925 |
|---|---|
| Former Name | MARY JANE LEYVA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 19403) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 19403) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2024-03-15 |