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Individual

MS. SYDNEY NATOSHA HUMPHREY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW, RPT-S

Contact information

Practice address
631 E. COURT ST., ATOKA, OK 74525
(580) 889-0960
Mailing address
P.O. BOX 51, ATOKA, OK 74525
(580) 889-0960

Taxonomy

Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
1041C0700X
Clinical Social Worker
Primary
4514
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4514
LCSW
OK
Enumeration date
08/25/2008
Last updated
06/21/2018
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