Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 775 | OK |
Y | 101YP2500X | Professional Counselor | 4464 | OK |
NPI | 1003014200 |
---|---|
Provider Name | Sharell Clydean Caton |
First Address | Ada, OK 74820-0058 |
Second Address | Ada, OK 74820-0058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 15/06/2014 |