Individual
MRS. STACIA A BUCHANAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSBS, LPC-S
Contact information
Practice address
1503 W GORE BLVD, LAWTON, OK 73501-3608
(580) 730-0232
(833) 279-4266
Mailing address
1503 W GORE BLVD, LAWTON, OK 73501-3608
(580) 730-0232
(833) 279-4266
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200440680A
—
OK
05
—
200949300
—
OK
Enumeration date
02/21/2007
Last updated
10/26/2022
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