Individual
MADONNA PERCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
4 SE AVE A, IDABEL, OK 74745-4620
(580) 286-5262
Mailing address
4 SE AVE A, IDABEL, OK 74745-4620
(580) 286-5262
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/16/2009
Last updated
12/16/2009
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