Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1659702165 |
---|---|
Provider Name | Clifford Blaine Morgan II |
First Address | Oklahoma City, OK 73105-1621 |
Second Address | Oklahoma City, OK 73105-1621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2013 |
Last Update Date | 13/09/2018 |