| NPI | 1942348644 | 
|---|---|
| Former Name | BETH DISBRO | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 9463) | 
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: TX 1937) | 
| Enumeration Date | 2007-02-02 | 
| Last Update Date | 2007-12-10 |