Individual
SANDY BOURGEOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
120 W BROADWAY ST, ALTUS, OK 73521-3802
(580) 471-0885
(580) 379-4010
Mailing address
120 W BROADWAY ST, ALTUS, OK 73521-3802
(580) 471-0885
(580) 379-4010
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
2833
OK
101YP2500X
Professional Counselor
Primary
2833
OK
Other
Enumeration date
08/05/2006
Last updated
04/23/2025
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