Individual
MRS. SUSAN RENEE YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
867 US HIGHWAY 70A, WILSON, OK 73463-1683
(580) 668-2337
(405) 573-0404
Mailing address
4001 KNIGHTS BRIDGE ST, NORMAN, OK 73072-1743
(405) 627-0276
(405) 573-0404
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3573
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006
SELECTCARE
OK
Enumeration date
05/17/2007
Last updated
07/08/2007
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