Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 4172 | OK |
N | 175L00000X | Homeopath |
NPI | 1649494303 |
---|---|
Provider Name | Mrs. Necole Marie Carpenter |
First Address | Sapulpa, OK 74067-1021 |
Second Address | Sapulpa, OK 74066-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 24/02/2016 |