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Individual

MRS. MICHELE DEANN BRAKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1101 E MONROE AVE, MCALESTER, OK 74501-4815
(918) 470-0285
(918) 426-5837
Mailing address
1127 S GEORGE NIGH EXPY, MCALESTER, OK 74501-7143
(918) 423-8440
(918) 421-2936

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC05503
OK
101YP2500X
Professional Counselor
LPC05503
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
101YM0800X
OK
05
163932071
OK
Enumeration date
10/06/2008
Last updated
10/24/2024
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