Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YS0200X | School Counselor | ||
Y | 103K00000X | Behavior Analyst | OK | |
N | 104100000X | Social Worker |
NPI | 1154605426 |
---|---|
Provider Name | Alicia D Bruner |
First Address | Oklahoma City, OK 73142-4515 |
Second Address | Oklahoma City, OK 73142-4515 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |