Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TR0400X | Rehabilitation Psychologist | OK |
NPI | 1548430036 |
---|---|
Provider Name | Regina Lynn Archer |
First Address | El Reno, OK 73036 |
Second Address | El Reno, OK 73036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/03/2008 |
Last Update Date | 31/12/2012 |