Individual
MRS. LOIS CRISP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, CM-D
Contact information
Practice address
209 W BROADWAY ST, OKEMAH, OK 74859-2618
(918) 623-2922
Mailing address
18111 GRAYSON BLVD, HENRYETTA, OK 74437-7258
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734620-B
—
OK
05
—
100734620-D
—
OK
Enumeration date
04/19/2007
Last updated
07/08/2007
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