Individual
MARY LOUISE NORDWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2010 BOREN BLVD, SEMINOLE, OK 74868-2050
(405) 382-4507
Mailing address
1131 E GARDENA ST, ADA, OK 74820-2413
(580) 235-7593
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/09/2010
Last updated
09/09/2010
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