Individual
TINA M POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1305 S COUNTRY CLUB RD, MUSKOGEE, OK 74403-7802
(918) 530-2342
Mailing address
PO BOX 392, WAGONER, OK 74477-0392
(918) 530-2342
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5383
OK
Other
Enumeration date
10/30/2012
Last updated
10/28/2014
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