Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 5010 | OK |
NPI | 1003117623 |
---|---|
Provider Name | Tiffany Scott |
First Address | Edmond, OK 73012-1205 |
Second Address | Oklahoma City, OK 73106-7220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2010 |
Last Update Date | 08/06/2021 |