Individual
MISS MARLA JANE DIVELBISS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7715 E GREENS AVE APT 105, BIXBY, OK 74008-5069
(918) 230-3934
Mailing address
7715 E GREENS AVE APT 105, BIXBY, OK 74008-5069
(918) 230-3934
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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