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Individual

MR. DENNIS RAY BLACKMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
608 W PERCH LN, ATOKA, OK 74525-4522
(580) 889-1067
Mailing address
608 W PERCH LN, ATOKA, OK 74525-4522
(580) 889-1067

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3134
OK

Other

Enumeration date
09/28/2006
Last updated
07/08/2007
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