Organization
THUNDER CANYON COUNSELING CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WILLIAM DAVIS PH.D. (CLINICAL DIRECTOR)
(580) 327-3846
Entity
Organization
Contact information
Practice address
1911 LOCUST ST, ALVA, OK 73717-1759
(580) 327-3846
Mailing address
1911 LOCUST ST, ALVA, OK 73717-1759
(580) 327-3846
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
1107
OK
Other
Enumeration date
05/21/2007
Last updated
10/28/2013
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