Individual
LAURA RANAE MICHENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 1267, MUSKOGEE, OK 74402-1267
(918) 380-0104
Mailing address
PO BOX 1267, MUSKOGEE, OK 74402-1267
(918) 380-0104
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
20925-P
OK
1041S0200X
School Social Worker
—
—
106S00000X
Behavior Technician
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/06/2022
Last updated
05/31/2024
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