Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | W082196158 | OK |
NPI | 1386913424 |
---|---|
Provider Name | Ms. Sasha Monique Oliver |
First Address | Oklahoma City, OK 73121-2430 |
Second Address | Oklahoma City, OK 73121-2430 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2011 |
Last Update Date | 19/12/2011 |