Individual
MARK AARON BRANSCUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2958
Mailing address
P.O. BOX 12978, OKLAHOMA CITY, OK 73157
(405) 858-2958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6074
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/04/2009
Last updated
07/20/2017
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