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Individual

MALLARY FLURRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2202 N BROADWAY ST, POTEAU, OK 74953-2000
(918) 649-0018
Mailing address
204 WALL ST, POTEAU, OK 74953-4400

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
OK
171M00000X
Case Manager/Care Coordinator
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NON
NOT AVAILABLE
Enumeration date
03/30/2016
Last updated
10/27/2022
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