NPI | 1649449760 |
---|---|
Former Name | MARY JANE PEREZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 121856) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 19406) |
101YP2500X Counselor, Professional (Licence: VA 0701004224) | |
Enumeration Date | 2008-02-22 |
Last Update Date | 2024-08-12 |