Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | OK |
NPI | 1003166158 |
---|---|
Provider Name | Julie Ann Novotny |
First Address | Yukon, OK 73099-6617 |
Second Address | Oklahoma City, OK 73112-6170 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2012 |
Last Update Date | 24/09/2013 |