Individual
KATELYN BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
108 W MAIN ST, TISHOMINGO, OK 73460-1723
(580) 371-3019
Mailing address
108 W MAIN ST, TISHOMINGO, OK 73460-1723
(580) 371-0139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/15/2021
Last updated
10/15/2021
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