Individual
LONNIE BLACKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6100 S WALKER AVE, OKLAHOMA CITY, OK 73139-7026
(405) 634-4400
Mailing address
6100 S WALKER AVE, OKLAHOMA CITY, OK 73139-7026
(405) 634-4400
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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