Individual
MS. BRENDA S BAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
27B SOUTH WEST, SUITE 100 & 200, ARDMORE, OK 73401
(918) 712-0859
(918) 388-6456
Mailing address
PO BOX 722, ADA, OK 74821-0722
(405) 210-1110
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2337
OK
Other
Enumeration date
07/17/2006
Last updated
07/08/2007
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