Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP2500X | Professional Counselor | ||
Y | 101YS0200X | School Counselor | 404312 | OK |
NPI | 1124407630 |
---|---|
Provider Name | Mrs. Tracy Renee Hull |
First Address | Edmond, OK 73025-2563 |
Second Address | Guthrie, OK 73044-5009 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2015 |
Last Update Date | 29/05/2015 |