Individual
DEBRA ANTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 SW 69TH STREET, LAWTON, OK 73505
(580) 574-0063
Mailing address
1501 SW 69TH STREET, LAWTON, OK 73505
(580) 574-0063
Taxonomy
Speciality
Code
Description
License number
State
103TR0400X
Rehabilitation Psychologist
Primary
—
—
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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