Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1336443910 |
---|---|
Provider Name | Mr. Bruce Kirkwood Brown JR. |
First Address | Oklahoma City, OK 73118-7043 |
Second Address | Oklahoma City, OK 73118-7043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2010 |
Last Update Date | 22/12/2010 |