Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1114159472 |
---|---|
Provider Name | Darlene Harbert |
First Address | Chandler, OK 74834-4219 |
Second Address | Chandler, OK 74834-4219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2009 |
Last Update Date | 19/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H082703326 | (05) | OK |