NPI | 1952596025 |
---|---|
Former Name | JIMMIE LORENZO THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSB94022230) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 00056469) |
Enumeration Date | 2007-09-11 |
Last Update Date | 2015-12-28 |