Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1225395874 |
---|---|
Provider Name | Maurice Murunga |
First Address | Bethany, OK 73008-5963 |
Second Address | Bethany, OK 73008-5963 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2012 |
Last Update Date | 20/04/2012 |