Individual
MICHEAL VISNIESKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
705 WEST MAIN, TISHOMINGO, OK 73406-1243
(580) 371-3799
Mailing address
29208 WACO ROAD, MCLOUD, OK 74851
(405) 642-2638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/14/2010
Last updated
10/14/2010
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