Individual
BERTHA MARIE GOSSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
Mailing address
607 NW 13TH ST, LAWTON, OK 73507-6525
(580) 514-3071
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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