Individual
MRS. LACI JOLEE CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
344176 E 5000 RD, PAWNEE, OK 74058-3751
(405) 742-2943
Mailing address
344176 E 5000 RD, PAWNEE, OK 74058-3751
(405) 742-2943
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OK
101YP2500X
Professional Counselor
Primary
3563
OK
Other
Enumeration date
02/15/2008
Last updated
07/09/2014
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