Individual
ANN MAYSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., LPC
Contact information
Practice address
1912 LAKE RD, PONCA CITY, OK 74604
(580) 762-6511
Mailing address
2509 ROBIN RD., PONCA CITY, OK 74604
(580) 763-1624
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4690
OK
Other
Enumeration date
07/27/2015
Last updated
07/27/2015
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