Individual
MR. TIMOTHY MICHAEL PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
718 E SEQUOYAH AVE, VINITA, OK 74301-3326
(918) 227-2016
Mailing address
PO BOX 209, VINITA, OK 74301-0209
(918) 244-1230
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
08/25/2011
Last updated
11/16/2020
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