Individual
GABRIELLE EVANGELINE BARNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCP, LADC/MH
Contact information
Practice address
200 WHITE EAGLE DR, PONCA CITY, OK 74601-8315
(580) 762-3421
Mailing address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
1421
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1421
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/19/2017
Last updated
02/28/2024
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