Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 6301015518 | MI |
Y | 103T00000X | Psychologist | 6301015518 | MI |
NPI | 1013347699 |
---|---|
Provider Name | Juliette Mott |
First Address | Houston, TX 77030 |
Second Address | Houston, TX 77030 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2013 |
Last Update Date | 19/11/2013 |