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Individual

ELIZABETH R MESSICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BHRS

Contact information

Practice address
4 SE AVE A, IDABEL, OK 74745-4620
(580) 286-5262
(580) 286-5595
Mailing address
PO BOX 286, BROKEN BOW, OK 74728-0286
(580) 743-1548

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200049040W
OK
Enumeration date
03/20/2012
Last updated
03/20/2012
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