Individual
LAURA BEASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
603 W MAIN ST, TISHOMINGO, OK 73460-1732
(580) 371-0433
Mailing address
PO BOX 61, HUGO, OK 74743-0061
(580) 371-0433
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/26/2010
Last updated
04/21/2021
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