Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1386963767 |
---|---|
Provider Name | Mrs. Chiquita Lynn Brown |
First Address | Midwest City, OK 73130-7412 |
Second Address | Oklahoma City, OK 73105-2804 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2010 |
Last Update Date | 24/05/2010 |