| NPI | 1992160683 |
|---|---|
| Former Name | GINA MARIE DAMRON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 80686) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL 13862) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2020-09-08 |