Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | OK630 | OK |
NPI | 1063524833 |
---|---|
Provider Name | Dr. Susan Stout Howard |
First Address | Norman, OK 73069-8580 |
Second Address | Norman, OK 73069-8580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 13/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100839310A | (05) | OK |