Individual
MARK SCOTT MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1500 N 6TH ST, EFCMHC, PONEA CITY, OK 74601
(580) 762-7561
(580) 762-2576
Mailing address
RR 2 BOX 28 25, FAIRFAX, OK 74637
(918) 642-3035
(580) 762-2576
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2593
OK
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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