Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 104100000X | Social Worker | OK | |
Y | 104100000X | Social Worker | 7962-P | OK |
NPI | 1003473364 |
---|---|
Provider Name | Mrs. Rebekah Elizabeth Kesler |
First Address | Vinita, OK 74301-4226 |
Second Address | Vinita, OK 74301-4226 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2019 |
Last Update Date | 28/06/2021 |