Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor |
NPI | 1043537434 |
---|---|
Provider Name | Mrs. Marian J King |
First Address | Tulsa, OK 74136-9010 |
Second Address | Claremore, OK 74019-2402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2010 |
Last Update Date | 29/04/2010 |