Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 719 | OK |
Y | 101YP2500X | Professional Counselor | 3340 | OK |
N | 101YS0200X | School Counselor | 300507 | OK |
NPI | 1104956507 |
---|---|
Provider Name | Cindy Brumley |
First Address | Broken Bow, OK 74728-8909 |
Second Address | Broken Bow, OK 74728-4525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2007 |
Last Update Date | 21/07/2012 |