Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1215253356 |
---|---|
Provider Name | Michael N Pryor |
First Address | Midwest City, OK 73110-3049 |
Second Address | Midwest City, OK 73110-3049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2010 |
Last Update Date | 14/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200092660A | (05) | OK |