Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | OK |
NPI | 1205123510 |
---|---|
Provider Name | Ms. Winona L Fitts |
First Address | Spencer, OK 73084-0176 |
Second Address | Oklahoma City, OK 73118-3231 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2011 |
Last Update Date | 02/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200467650A | (05) | OK |