Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 997 | OK |
Y | 103T00000X | Psychologist | 997 | OK |
N | 103TH0100X | Health Service | 997 | OK |
NPI | 1174690788 |
---|---|
Provider Name | Dr. Sharon Lamoyne Kerr |
First Address | Stillwater, OK 74074-4105 |
Second Address | Stillwater, OK 74074-4105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 27/07/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200021990A | (05) | OK |