Individual
MARY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9800 N 100TH EAST AVE, OWASSO, OK 74055-6491
(918) 609-3006
Mailing address
9800 N 100TH EAST AVE, OWASSO, OK 74055-6491
(918) 740-4118
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7755
OK
Other
Enumeration date
06/19/2019
Last updated
09/11/2023
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