Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1154657906 |
---|---|
Provider Name | Brian Louis Starchman |
First Address | Miami, OK 74354-7629 |
Second Address | Miami, OK 74354-7629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2009 |
Last Update Date | 29/10/2009 |