Organization
MICHELLE RAYBURN, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE J RAYBURN LCSW (OWNER)
(405) 202-1331
Entity
Organization
Contact information
Practice address
5015 N PENNSYLVANIA AVE, SUITE # 200, OKLAHOMA CITY, OK 73112-8891
(405) 202-1331
(405) 796-7260
Mailing address
5015 N PENNSYLVANIA AVE, SUITE #200, OKLAHOMA CITY, OK 73112-8891
(405) 202-1331
(405) 796-7260
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
OK3673
OK
Other
Enumeration date
01/06/2011
Last updated
09/12/2011
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