Individual
MIKE NEWBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
716 S 2ND ST, STILWELL, OK 74960-4806
(918) 775-7787
Mailing address
205 J T STITES BLVD, SALLISAW, OK 74955-9301
(918) 775-7787
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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