Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YS0200X | School Counselor | ||
N | 103K00000X | Behavior Analyst | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist |
NPI | 1235657842 |
---|---|
Provider Name | Jacque S Komers |
First Address | Kingfisher, OK 73750 |
Second Address | Oklahoma City, OK 73116 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2017 |
Last Update Date | 04/09/2017 |