Individual
SUSAN L. ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
300 FAIRVIEW AVE STE 2, PONCA CITY, OK 74601-2056
(580) 762-2222
(580) 762-2229
Mailing address
300 FAIRVIEW AVE STE 2, PONCA CITY, OK 74601-2056
(580) 762-2222
(580) 762-2229
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2895
OK
Other
Enumeration date
07/02/2010
Last updated
02/26/2011
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