Organization
CLAREMORE COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE C WALLACE L.C.S.W. (OWNER)
(918) 344-4848
Entity
Organization
Contact information
Practice address
115 1/2 W BLUE STARR DR, CLAREMORE, OK 74017-4226
(918) 344-4848
Mailing address
115 1/2 W BLUE STARR DR, CLAREMORE, OK 74017-4226
(918) 344-4848
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2449
OK
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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