Individual
BRADLEY WAYNE HOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
1212 E KIRK ST, HUGO, OK 74743-3607
(580) 326-5279
Mailing address
1212 E KIRK ST, HUGO, OK 74743-3607
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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