Individual
MARY QUALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 N. MAGNOLIA ST., WISTER, OK 74966
(918) 647-6766
Mailing address
PO BOX 685, 1101 N. MAGNOLIA ST., WISTER, OK 74966-0685
(918) 647-6766
Taxonomy
Speciality
Code
Description
License number
State
225C00000X
Rehabilitation Counselor
Primary
—
—
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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