Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 18429 | TX |
N | 101YS0200X | School Counselor | TX |
NPI | 1124291216 |
---|---|
Provider Name | Mary Saint Dumlao |
First Address | Magnolia, TX 77354-5712 |
Second Address | Cypress, TX 77429-7831 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2008 |
Last Update Date | 13/02/2009 |