Individual
AUDREY JUNE HALFACRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS, MHA
Contact information
Practice address
4803 RIDGE ST, TAHLEQUAH, OK 74464-5644
(918) 316-0130
Mailing address
4803 RIDGE ST, TAHLEQUAH, OK 74464-5644
(918) 316-0130
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
02/04/2020
Last updated
01/08/2021
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