Individual
LAURA ANNE PEITZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC
Contact information
Practice address
3415 MEADOW LN, PONCA CITY, OK 74604-1318
(580) 762-5948
Mailing address
3415 MEADOW LN, PONCA CITY, OK 74604-1318
(580) 762-5948
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3813
OK
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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