Individual
CARLY BURCHETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1320 E 9TH ST STE 5, EDMOND, OK 73034-5773
(405) 509-9194
Mailing address
1320 E 9TH ST STE 5, EDMOND, OK 73034-5773
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10593
OK
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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