Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013282284 |
---|---|
Provider Name | Ms. Sherie Cantrell |
First Address | Stillwater, OK 74074-2402 |
Second Address | Stillwater, OK 74074-2402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2012 |
Last Update Date | 20/03/2012 |