Individual
THERESA M HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
114 N GRAND AVE, OKMULGEE, OK 74447-4013
(918) 519-9606
Mailing address
114 N GRAND AVE, OKMULGEE, OK 74447-4013
(918) 519-9606
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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