Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 2687 | OK |
N | 101YS0200X | School Counselor | 172889 | OK |
NPI | 1093025413 |
---|---|
Provider Name | Mrs. Veronica Marie Miller |
First Address | Hartshorne, OK 74547-2836 |
Second Address | Wilburton, OK 74578-4047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2010 |
Last Update Date | 19/10/2010 |