Individual
GAMALIEL MANANGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 S SYCAMORE PL, BROKEN ARROW, OK 74012-8367
(918) 955-8434
Mailing address
314 S SYCAMORE PL, BROKEN ARROW, OK 74012-8367
(918) 955-8434
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/02/2016
Last updated
03/02/2016
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