Individual
AMIE ELAINE PICKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCP
Contact information
Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
Mailing address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 352-1752
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/25/2016
Last updated
01/28/2020
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