Individual
MICAH JAY ALLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. LPC-C
Contact information
Practice address
1140 MAYBERRY DR, TAHLEQUAH, OK 74464-4603
(918) 453-1108
(918) 453-1108
Mailing address
1140 MAYBERRY DR, TAHLEQUAH, OK 74464-4603
(918) 453-1108
(918) 453-1108
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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