Individual
MR. HENRY LEE GAINES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CM
Contact information
Practice address
3621 N KELLEY AVE, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
3621 N KELLEY AVE, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251B00000X
Case Management Agency
Primary
—
OK
Other
Enumeration date
12/09/2011
Last updated
09/04/2013
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