Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1588850440 |
---|---|
Provider Name | John Joseph Aguirre |
First Address | Antlers, OK 74523-2215 |
Second Address | Antlers, OK 74523-2215 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2007 |
Last Update Date | 20/08/2009 |