| NPI | 1851422786 |
|---|---|
| Former Name | PAULETTE D CIVICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: TX 34263) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 19902) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2012-05-18 |