Individual
MR. LARRY MCCALLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA,LPC
Contact information
Practice address
5116 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2077
(405) 556-0912
Mailing address
5116 N PORTLAND AVE, OKLAHOMA CITY, OK 73112-2077
(405) 556-0912
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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