Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor | OK |
NPI | 1306155981 |
---|---|
Provider Name | Shirley D Reed |
First Address | Tahlequah, OK 74464-4734 |
Second Address | Tahlequah, OK 74464-4734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2010 |
Last Update Date | 30/09/2010 |