Organization
EVA HARTLEY LPC LADC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHEL EVA HARTLEY LPC LADC (OWNER)
(405) 240-2469
Entity
Organization
Contact information
Practice address
414 W MONROE ST, PURCELL, OK 73080-3208
(405) 420-2469
Mailing address
414 W. MONROE, PUECELL, OK 74878
(405) 420-2469
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
5490
OK
Other
Enumeration date
05/11/2015
Last updated
05/11/2015
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