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Individual

MR. CHIEF EZEALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
B.A.

Contact information

Practice address
1713 VICTORIA DR, EDMOND, OK 73003-3860
(405) 818-1841
Mailing address
1713 VICTORIA DR, EDMOND, OK 73003-3860
(405) 818-1841

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
05/21/2010
Last updated
05/21/2010
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