Individual
MRS. MICHELLE LEE GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LBP, CCRC
Contact information
Practice address
2801 PARKLAWN DR STE 303, MIDWEST CITY, OK 73110-4230
(405) 610-3644
(405) 610-3647
Mailing address
2801 PARKLAWN DR STE 303, MIDWEST CITY, OK 73110-4230
(405) 245-9233
(405) 610-3647
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0089
OK
101YP2500X
Professional Counselor
Primary
0089
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200330740B
—
OK
Enumeration date
11/25/2009
Last updated
12/30/2020
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