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Individual

MS. CONNIE CODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, LPC-CANDIDATE

Contact information

Practice address
608 HIGHWAY 271 N, ANTLERS, OK 74523-2055
(580) 298-5062
(580) 298-9958
Mailing address
PO BOX 374, ANTLERS, OK 74523-0374
(580) 298-5062
(580) 298-9958

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200111200A
OK
Enumeration date
04/25/2011
Last updated
04/25/2011
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