Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 3863 | OK |
NPI | 1003067430 |
---|---|
Provider Name | Donita K Goodin |
First Address | Norman, OK 73026-2752 |
Second Address | Norman, OK 73026-2752 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2008 |
Last Update Date | 03/10/2008 |