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Individual
CAROL ELLISE O'BRYAN
Active
Individual
CAROL ELLISE O'BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2006029726
MO
101YP2500X
Professional Counselor
4025
OK
106H00000X
Marriage & Family Therapist
2007002866
MO
106H00000X
Marriage & Family Therapist
798
TN
106H00000X
Marriage & Family Therapist
Primary
895
OK
Other
Enumeration date
12/07/2006
Last updated
06/27/2012
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