Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | T082243745 | OK |
NPI | 1235432444 |
---|---|
Provider Name | Mrs. Charis Kay Griffin |
First Address | Antlers, OK 74523-2045 |
Second Address | Antlers, OK 74523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2010 |
Last Update Date | 09/12/2010 |