Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003141870 |
---|---|
Provider Name | Deborah Colbert |
First Address | Jenks, OK 74037-3100 |
Second Address | Jenks, OK 74037-3100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2009 |
Last Update Date | 12/10/2009 |