Organization
RENEGADE COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBBY GENE PLYMALE LPC (CLINICAL DIRECTOR)
(918) 427-3944
Entity
Organization
Contact information
Practice address
809-B SOUTH BIRCH STREET, MULDROW, OK 74948
(918) 427-3944
Mailing address
PO BOX 262, MULDROW, OK 74948-0262
(918) 427-3944
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5354
OK
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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