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Organization

RENEE P YOUNG, MS, LMFT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RENEE PAULINE YOUNG MS, LMFT (OWNER)
(580) 304-2069
Entity
Organization

Contact information

Practice address
222 E GRAND AVE STE 300, PONCA CITY, OK 74601-4316
(405) 939-0559
(580) 916-9538
Mailing address
2412 DONNER AVE., PONCA CITY, OK 74604
(580) 304-2069
(580) 916-9538

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1136
OK
106H00000X
Marriage & Family Therapist
Primary
1136
OK

Other

Enumeration date
08/22/2018
Last updated
08/22/2018
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