Individual
MR. BRYAN K LARISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., L.P.C
Contact information
Practice address
1500 N 6TH ST, PONCA CITY, OK 74601-2827
(580) 762-7561
Mailing address
1401 E CEDAR CT, STILLWATER, OK 74075-7941
(405) 372-1167
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2545
OK
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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