| NPI | 1821169996 |
|---|---|
| Former Name | LAURA LYNNE MARTINEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: TX 32144) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: TX 32144) |
| 103TS0200X Psychologist, School (Licence: TX 32458) | |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2016-01-25 |