Individual
MS. MAXINE DIANA MCKOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
THERAPIST/COUNSELOR
Contact information
Practice address
1843 E 15TH ST, TULSA, OK 74104-4610
(918) 951-5727
Mailing address
PO BOX 2231, SAPULPA, OK 74067-2231
(918) 951-5727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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