Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1043539760 |
---|---|
Provider Name | Andrea Michelle Parkhurst |
First Address | Elk City, OK 73644-1906 |
Second Address | Elk City, OK 73644-1906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2010 |
Last Update Date | 20/05/2010 |