Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 3407 | OK |
NPI | 1003029729 |
---|---|
Provider Name | Ms. Judy L. Lindstrom |
First Address | Oklahoma City, OK 73112-2212 |
Second Address | Oklahoma City, OK 73103-3918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 04/08/2008 |