Individual
AUTUMN ANTHONY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
408 NW PONTOTOC ST, MINCO, OK 73059-2070
(405) 414-0179
Mailing address
408 NW PONTOTOC ST, MINCO, OK 73059-2070
(405) 414-0179
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
OK
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/15/2020
Last updated
06/25/2024
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