Individual
MRS. ZELLA MARIE BEAUFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC CANDIDATE
Contact information
Practice address
RR 1, BOLEY, OK 74829
(918) 667-3367
(918) 667-3387
Mailing address
PO BOX 218, BOLEY, OK 74829-0218
(918) 667-3367
(918) 667-3387
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC CANDIDATE
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100685660A
—
OK
05
—
100685660D
—
OK
Enumeration date
07/26/2010
Last updated
07/26/2010
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