Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1215277835 |
---|---|
Provider Name | Mikella A Whatley |
First Address | Hennepin, OK 73444-0233 |
Second Address | Ardmore, OK 73401-2280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2013 |
Last Update Date | 19/02/2013 |