Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) |
NPI | 1003252388 |
---|---|
Provider Name | Ms. Brittany Stoutermire |
First Address | Oklahoma City, OK 73111-4520 |
Second Address | Oklahoma City, OK 73111-4520 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2013 |
Last Update Date | 14/05/2013 |