Individual
GLEN COURTNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 E 45TH ST, SHAWNEE, OK 74804-2202
(405) 273-1170
Mailing address
1010 E 45TH ST, SHAWNEE, OK 74804-2202
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LMFTCANDIDATE12263
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/29/2022
Last updated
07/24/2024
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