Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1235462177 |
---|---|
Provider Name | James Clayton Fiddler |
First Address | Miami, OK 74354-7629 |
Second Address | Miami, OK 74354-7629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2009 |
Last Update Date | 10/09/2009 |