Organization
MICHELLE BLANK, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLANK BLANK (PRESIDENT)
(918) 230-9464
Entity
Organization
Contact information
Practice address
501 E 15TH ST, 500A, EDMOND, OK 73013-5043
(405) 888-5299
Mailing address
501 E 15TH ST, 500A, EDMOND, OK 73013-5043
(405) 888-5299
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2265
OK
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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