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Individual

MRS. EBONY MICHELLE THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BHWC

Contact information

Practice address
4300 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5107
(405) 425-0486
(405) 419-3007
Mailing address
17005 PRESTWICK CIR, EDMOND, OK 73012-7405
(405) 425-0486
(405) 419-3007

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/27/2017
Last updated
09/27/2017
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