Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1316211493 |
---|---|
Provider Name | Alisa Zonin |
First Address | Tulsa, OK 74115-5743 |
Second Address | Tulsa, OK 74115-5743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2012 |
Last Update Date | 06/03/2012 |