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Individual

DE'LICIA BURRELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1716 N GLADE AVE, BETHANY, OK 73008-5419
(580) 212-7335
Mailing address
1716 NORTH GLADE AVE, BETHANY, OK 73008

Taxonomy

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

Other

Enumeration date
11/08/2011
Last updated
11/08/2011
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