Individual
MISTY J MAGNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
604 CHOCTAW ST, ALVA, OK 73717-1626
(580) 327-1112
Mailing address
604 CHOCTAW ST, ALVA, OK 73717-1626
(580) 327-1112
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200749050A
—
OK
Enumeration date
01/17/2018
Last updated
03/15/2021
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