Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1528489937 |
---|---|
Provider Name | Malerie Guilbeau |
First Address | Sand Springs, OK 74063-8901 |
Second Address | Sand Springs, OK 74063-8901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2014 |
Last Update Date | 02/01/2014 |