NPI | 1588902969 |
---|---|
Former Name | KRYSTAL T. COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 36257) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 34572) |
Enumeration Date | 2013-01-20 |
Last Update Date | 2016-08-23 |