Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | 39002637A | IN |
Y | 103TC1900X | Counseling Psychologist | 20042247A | IN |
N | 103TH0004X | Health Psychologist | 20042247A | IN |
N | 103TH0100X | Health Service | 20042247A | IN |
NPI | 1568971513 |
---|---|
Provider Name | David B. Simpson |
First Address | Tulsa, OK 74136-5056 |
Second Address | Tulsa, OK 74136-5056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2017 |
Last Update Date | 21/09/2017 |