Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) |
NPI | 1629306626 |
---|---|
Provider Name | Miss Connie Raye Murray |
First Address | Oklahoma City, OK 73105-2832 |
Second Address | Oklahoma City, OK 73105-2832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2009 |
Last Update Date | 10/02/2016 |