Organization
DIVERSIFIED CONSULTING, INC.
Active
Other names
Center for Psychological Development
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STACEY GIBSON MBS, LPC, CART (PRESIDENT/CHIEF EXECUTIVE OFFICER)
(903) 868-2961
Entity
Organization
Contact information
Practice address
142 W MAIN ST, DURANT, OK 74701-5008
(580) 920-2069
(580) 920-1010
Mailing address
142 W MAIN ST, DURANT, OK 74701-5008
(580) 920-2069
(580) 920-1010
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
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