Individual
BRAYDEN LANE MCCLARTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
527 W 3RD ST, KONAWA, OK 74849-1415
(405) 584-4078
Mailing address
527 W 3RD ST, KONAWA, OK 74849-1415
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
20946-P
OK
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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