Individual
MRS. MICHELLE JEANETTE RAYBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5015 N PENNSYLVANIA AVE, SUITE 200, OKLAHOMA CITY, OK 73112-8891
(405) 202-1331
(405) 796-7260
Mailing address
PO BOX 5022, EDMOND, OK 73083-5022
(405) 202-1331
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3673
OK
Other
Enumeration date
11/22/2008
Last updated
09/08/2011
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