Organization
ADVOCATES FOR CHANGE FAMILY SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARY JO BRAZIER LCSW (LCSW, SOLE OWNER)
(405) 615-2447
Entity
Organization
Contact information
Practice address
610 N. BROADWAY AVE,, SHAWNEE, OK 74801-6202
(405) 615-2447
(405) 432-5071
Mailing address
PO BOX 3202, SHAWNEE, OK 74802
(405) 615-2447
(405) 432-5071
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200842400A
—
OK
Enumeration date
04/23/2019
Last updated
11/24/2023
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