Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1336424654 |
---|---|
Provider Name | Kerry M Hughart |
First Address | Muskogee, OK 74403-7802 |
Second Address | Muskogee, OK 74403-7802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2011 |
Last Update Date | 18/10/2011 |