Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | OK |
NPI | 1730420142 |
---|---|
Provider Name | Marilyn Chatman |
First Address | Oklahoma City, OK 73112-7070 |
Second Address | Oklahoma City, OK 73112-7070 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2013 |
Last Update Date | 11/03/2013 |