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Individual

AMISTA DANIELLE CHAMBERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, LPC

Contact information

Practice address
2310 E GORE BLVD, #5, LAWTON, OK 73501-6130
(580) 699-2202
(580) 699-2207
Mailing address
4010 SE CAMELOT DR, LAWTON, OK 73501-8438
(580) 699-2202
(580) 699-2207

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5182
OK

Other

Enumeration date
07/01/2011
Last updated
02/06/2015
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