Individual
MS. DIANNA LYNN PHARAOH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
36609 45TH ST, SHAWNEE, OK 74804-8882
(405) 273-1170
Mailing address
36605 45TH ST, SHAWNEE, OK 74804-8882
(405) 054-2731
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC02228
OK
101YP2500X
Professional Counselor
Primary
LPC02228
OK
Other
Enumeration date
12/22/2021
Last updated
03/10/2025
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