Individual
MARY A HENRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12305 PITTSBURGH 'AVE.', OKLAHOMA CITY, OK 73120
(405) 748-4782
Mailing address
12305 PITTSBURGH AVE, OKLAHOMA CITY, OK 73120
(405) 748-4782
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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