Individual
MS. LISA M. CRAGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LPC
Contact information
Practice address
204 JO ST, TAHLEQUAH, OK 74464-4013
(918) 207-5700
Mailing address
204 JO ST, TAHLEQUAH, OK 74464-4013
(918) 207-5700
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4142
OK
183700000X
Pharmacy Technician
T-7063
OK
Other
Enumeration date
07/29/2005
Last updated
06/23/2010
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