Individual
AMANDA BOURNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
900 N BROADWAY ST, STE 1, POTEAU, OK 74953-2617
(918) 649-0772
Mailing address
15681 AVIS CIR, SPIRO, OK 74959-4005
(479) 981-0007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/30/2013
Last updated
07/30/2013
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