Individual
CATHY MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
205 S JT STITES BLVD, SALLISAW, OK 74955-9301
(918) 775-7787
(918) 775-3580
Mailing address
210 S JT STITES BLVD, SALLISAW, OK 74955-9301
(918) 775-7787
(918) 775-0328
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3692
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200360410A
—
OK
Enumeration date
02/20/2008
Last updated
02/14/2024
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