Individual
BRENDA SUE MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26795 E 142ND ST S, COWETA, OK 74429-5704
(918) 698-7171
Mailing address
26795 E 142ND ST S, COWETA, OK 74429-5704
(918) 698-7171
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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