Individual
MRS. CARLA SUE BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., L.B.P.
Contact information
Practice address
3103 E JACKSON ST, HUGO, OK 74743-4051
(580) 326-5279
Mailing address
173 W RUTH AVE, ATOKA, OK 74525-4001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0072
OK
Other
Enumeration date
01/22/2007
Last updated
04/07/2016
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