Healthcare Provider Details

I. General information

NPI: 1407109788
Provider Name (Legal Business Name): VAL GENE GOKEY M.ED.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2012
Last Update Date: 10/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 SHADY GROVE RD
MCLOUD OK
74851-8152
US

IV. Provider business mailing address

32 SHADY GROVE RD
MCLOUD OK
74851-8152
US

V. Phone/Fax

Practice location:
  • Phone: 405-964-2793
  • Fax:
Mailing address:
  • Phone: 405-964-2793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number146192 L
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: