Individual
MRS. DANIELLE CHARLOTTE MARIE HOLMSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14625 NE 23RD ST, CHOCTAW, OK 73020-8728
(405) 390-8131
Mailing address
2433 SW 54TH ST, OKLAHOMA CITY, OK 73119-6019
(405) 532-7608
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5797
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200481330B
—
OK
Enumeration date
01/09/2013
Last updated
02/23/2016
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