Individual
MICHELLE LOUGHLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11708 NW 118TH ST, YUKON, OK 73099-8108
(405) 618-3012
Mailing address
11708 NW 118TH ST, YUKON, OK 73099-8108
(405) 618-3012
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2148
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148
LICENSING STATE
OK
Enumeration date
01/31/2019
Last updated
01/31/2019
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