Individual
MARIE IRENE LOUCKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
204 MAIN ST, BROKEN BOW, OK 74728-3976
(580) 584-2478
Mailing address
505 QUARTZ RD, HAWORTH, OK 74740-5388
(580) 916-2357
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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