Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1225426208 |
---|---|
Provider Name | Carla Muldrow |
First Address | Tulsa, OK 74107-9530 |
Second Address | Tulsa, OK 74105-6317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2014 |
Last Update Date | 28/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100746170G | (05) | OK |