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Individual

DENNIS CHARLES CROOKEDACRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
8937 S GARNETT RD, BROKEN ARROW, OK 74012-6004
(918) 872-9777
(918) 872-9779
Mailing address
2990 N SIOUX AVE, CLAREMORE, OK 74017-3700
(918) 342-2622
(918) 342-2641

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4471
OK
101YP2500X
Professional Counselor
6401010401
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4471
LICENSE
OK
Enumeration date
12/03/2008
Last updated
08/06/2015
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