Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013276245 |
---|---|
Provider Name | Mrs. Tabitha D Zurovetz |
First Address | Wilburton, OK 74578-4815 |
Second Address | Wilburton, OK 74578-4815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2012 |
Last Update Date | 08/05/2012 |