NPI | 1740980101 |
---|---|
Former Name | LISA D COCHRAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: TX 39687) |
Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: TX 39687) |
103TS0200X Psychologist, School (Licence: TX 32193) | |
Enumeration Date | 2023-03-06 |
Last Update Date | 2023-09-26 |