| NPI | 1679649313 |
|---|---|
| Former Name | JOAN MARYLYN REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TX 15357) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 003689016822) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2007-07-08 |