Individual
SAMPSON HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1729 W 33RD ST, SUITE NUMBER B, EDMOND, OK 73013-3835
(405) 216-5608
Mailing address
1729 W 33RD ST, SUITE NUMBER B, EDMOND, OK 73013-3835
(405) 216-5608
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/10/2012
Last updated
08/10/2012
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