Individual
LISA LAUDERDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24797 S HWY 66, SUITE 5, CLAREMORE, OK 74019-2411
(918) 342-2080
(918) 342-0075
Mailing address
20404 E 410 ROAD, CHELSEA, OK 74016
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/01/2008
Last updated
02/10/2012
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