Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 3531 | OK |
NPI | 1093920134 |
---|---|
Provider Name | Candas Golden |
First Address | Norman, OK 73072-4017 |
Second Address | Norman, OK 73069-7257 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |