| NPI | 1881605665 |
|---|---|
| Former Name | DIANE O'MEARA BROADY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 16692) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2011-12-20 |