Individual
MRS. CONNIE LAFAVE GALLUPE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
113 W MILES AVE, KINGFISHER, OK 73750-2645
(405) 375-7270
Mailing address
1203 COLEMAN TRL, KINGFISHER, OK 73750-4506
(405) 375-7270
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3520
OK
Other
Enumeration date
09/02/2010
Last updated
09/02/2010
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