Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | OK |
NPI | 1083967848 |
---|---|
Provider Name | Kristy R Caudle |
First Address | Oklahoma City, OK 73162-1634 |
Second Address | Oklahoma City, OK 73162-1634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2012 |
Last Update Date | 18/10/2012 |