Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 7601 | OK |
NPI | 1003576349 |
---|---|
Provider Name | Quentin Sigman |
First Address | Tahlequah, OK 74464-7932 |
Second Address | Tahlequah, OK 74464-0545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2021 |
Last Update Date | 28/12/2021 |