Individual
HIPPOLITUS EZEALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1713 VICTORIA DR, EDMOND, OK 73003-3860
(706) 836-1893
Mailing address
1713 VICTORIA DR, EDMOND, OK 73003-3860
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/11/2013
Last updated
11/11/2013
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