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Individual

DANETTE MCCORKLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2700
Mailing address
1129 WESTCHESTER DR, OKLAHOMA CITY, OK 73114-1619
(405) 840-5278

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10
OK
Enumeration date
07/15/2010
Last updated
07/15/2010
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