Individual
MONA GROUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
512 E 24TH ST, TISHOMINGO, OK 73460-3214
(580) 371-3672
Mailing address
2701 W UNIVERSITY BLVD, DURANT, OK 74701-2997
(580) 740-4053
(877) 725-8976
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5800
OK
Other
Enumeration date
03/21/2011
Last updated
12/31/2025
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