Individual
MRS. MONA GAY BRENNEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS IN PSYCHOLOGY
Contact information
Practice address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 749-5056
(580) 215-5756
Mailing address
407 W SOUTH AVE, PONCA CITY, OK 74601-6133
(580) 749-5056
(580) 215-5756
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
00815
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
1028
OK
101YP2500X
Professional Counselor
03353
KS
101YP2500X
Professional Counselor
Primary
05910
OK
Other
Enumeration date
03/15/2007
Last updated
08/05/2025
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