Individual
BREYONNE MICHELLE COSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5717 NW LADY MARNA AVE, LAWTON, OK 73507
(580) 574-7703
Mailing address
602 SW 38TH ST, LAWTON, OK 73505-6912
(580) 248-5780
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6714
OK
Other
Enumeration date
04/29/2013
Last updated
01/30/2025
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