Individual
BRIAN MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
700 S TELEPHONE RD, MOORE, OK 73160-2550
(405) 912-3495
Mailing address
307 HORIZON VIEW CT, NORMAN, OK 73071-4165
(405) 606-1500
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
7586
OK
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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