NPI | 1396829065 |
---|---|
Former Name | STACY ANN MARKUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 174H00000X Health Educator (Licence: OK 21410447) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 3570) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2015-09-21 |