Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003033788 |
---|---|
Provider Name | Jacqueline Ann Norvell |
First Address | Piedmont, OK 73078-7414 |
Second Address | Kingfisher, OK 73750-2720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 31/12/2012 |