Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003169004 |
---|---|
Provider Name | Jessica Stevie Schrameck |
First Address | Oklahoma City, OK 73106 |
Second Address | Oklahoma City, OK 73106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 16/10/2012 |