Individual
DANIELLE J BLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 W ADA AVE, WILBURTON, OK 74578-2416
(918) 297-3400
Mailing address
225 W ADAMS AVE, MCALESTER, OK 74501-4307
(918) 424-5769
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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