Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1568899144 |
---|---|
Provider Name | Fay O'neill |
First Address | Bartlesville, OK 74003-5939 |
Second Address | Bartlesville, OK 74003-3847 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2013 |
Last Update Date | 28/10/2013 |