Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 3020 | OK |
NPI | 1003002213 |
---|---|
Provider Name | Danna Cobble |
First Address | Moore, OK 73160-3924 |
Second Address | Moore, OK 73160-3924 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2007 |
Last Update Date | 30/08/2010 |