Individual
MRS. MISTY MARIE RAYMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
216 W 14TH ST, SULPHUR, OK 73086-6628
(580) 993-0784
Mailing address
216 W 14TH ST, SULPHUR, OK 73086-6628
(580) 993-0784
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100708380
—
OK
05
—
200049040
—
OK
Enumeration date
08/23/2013
Last updated
08/26/2013
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