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 |