Individual
DEBORAUGH DE ANN ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24332 E 757 RD, TAHLEQUAH, OK 74464-1949
(918) 431-4514
Mailing address
24332 E 757 RD, TAHLEQUAH, OK 74464-1949
(918) 431-4514
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00724340
PTIN
—
Enumeration date
05/12/2014
Last updated
05/12/2014
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