Individual
MR. DOUGLAS RAY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
1340 N EASTERN AVE, MOORE, OK 73160-5742
(405) 517-7679
(405) 831-8506
Mailing address
1340 N EASTERN AVE, MOORE, OK 73160-5742
(405) 517-7679
(405) 831-8506
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
714
OK
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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