Individual
MS. BRENDA RAQUEL CRAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8901 S SANTA FE AVE STE E, OKLAHOMA CITY, OK 73139-8413
(405) 605-5757
(405) 605-5775
Mailing address
912 SW 36TH ST, MOORE, OK 73160-7696
(405) 570-3139
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
189357L
OK
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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