Individual
LACY BONHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3750 W MAIN ST STE AA, NORMAN, OK 73072-4645
(405) 824-8378
Mailing address
3682 MERLIN CT, NEWCASTLE, OK 73065-5520
(580) 458-9300
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
10/23/2020
Last updated
10/23/2020
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