Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 189 | OK |
Y | 101YP2500X | Professional Counselor | 2157 | OK |
NPI | 1003831181 |
---|---|
Provider Name | Ms. Mary Ann Spaulding |
First Address | Norman, OK 73072 |
Second Address | Norman, OK 73069 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 12/12/2019 |