Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor |
NPI | 1003294935 |
---|---|
Provider Name | Candice Catoire |
First Address | Yukon, OK 73099-6754 |
Second Address | Yukon, OK 73099-6754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2015 |
Last Update Date | 26/01/2016 |