Individual
MS. MARY ELIZABETH GUNNELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RSS
Contact information
Practice address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
(580) 353-6798
Mailing address
602 SW 38TH STREET, LAWTON, OK 73505
(580) 248-5780
(580) 353-6798
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
036
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
736017987
—
OK
Enumeration date
12/16/2010
Last updated
12/16/2010
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