Individual
ANGELA MACKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
154 COONROD AVE, MANNFORD, OK 74044-7404
(918) 281-5465
Mailing address
PO BOX 1344, MANNFORD, OK 74044-1344
(918) 281-5465
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200686700B
—
OK
Enumeration date
02/03/2017
Last updated
12/15/2020
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