Individual
MARVIC REY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7301 BROADWAY EXT, OKLAHOMA CITY, OK 73116-9045
(405) 767-1126
Mailing address
7301 BROADWAY EXT, OKLAHOMA CITY, OK 73116-9045
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
J082239835
—
OK
Enumeration date
10/05/2012
Last updated
10/05/2012
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