Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 1619 | OK |
N | 103TS0200X | School Psychologist | OK |
NPI | 1063931509 |
---|---|
Provider Name | Nicole Barlow |
First Address | Norman, OK 73071-6182 |
Second Address | Norman, OK 73071-6182 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2017 |
Last Update Date | 15/09/2017 |