Individual
DEBORAH A FALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC UNDER SUPERVISIO
Contact information
Practice address
1705 CRADDUCK RD, ADA, OK 74820
(580) 310-9000
Mailing address
PO BOX 1311, ADA, OK 74821-1311
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
UNDER SUPERVISION
—
Other
Enumeration date
05/23/2007
Last updated
01/28/2008
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