Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1639451347 |
---|---|
Provider Name | Mr. James Austin Mcvay JR. |
First Address | Edmond, OK 73003-5073 |
Second Address | Edmond, OK 73003-5073 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2011 |
Last Update Date | 20/09/2011 |