Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003249772 |
---|---|
Provider Name | Sherri Mccoy |
First Address | Atoka, OK 74525-2047 |
Second Address | Atoka, OK 74525-2047 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2013 |
Last Update Date | 16/08/2013 |