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Individual

MRS. MARYLEE NANNELL GASKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
3015 E SKELLY DR, SUITE103, TULSA, OK 74105-6317
(918) 712-0859
(918) 388-9708
Mailing address
302 E 19TH ST, OWASSO, OK 74055-4612
(918) 712-0859
(918) 388-9708

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100746170
OK
Enumeration date
11/05/2013
Last updated
06/27/2014
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