Individual
MARY K COUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-SUPERVISION
Contact information
Practice address
4149 HIGHLINE BLVD, SUITE 400, OKLAHOMA CITY, OK 73108-2103
(405) 949-1000
(405) 949-1063
Mailing address
720 S BLAKELY ST, STILLWATER, OK 74074-4327
(405) 338-8945
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200049040
—
OK
Enumeration date
02/23/2012
Last updated
02/23/2012
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