| NPI | 1831685759 |
|---|---|
| Former Name | JACQUELINE V LALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 92836) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: LA 7452) |
| Enumeration Date | 2018-07-03 |
| Last Update Date | 2023-09-25 |