Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003135575 |
---|---|
Provider Name | Ms. Elsie Nicole Winston |
First Address | Oklahoma City, OK 73141-2226 |
Second Address | Atoka, OK 74525-4104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2010 |
Last Update Date | 24/05/2010 |