Individual
MARY LEE DASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COUNSELOR
Contact information
Practice address
1304 POLK ST, ALTUS, OK 73521-4542
(580) 477-0824
(580) 477-0984
Mailing address
1304 POLK ST, ALTUS, OK 73521-4542
(580) 477-0824
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
156
OK
101YA0400X
Addiction (Substance Use Disorder) Counselor
9458
TX
Other
Enumeration date
04/26/2010
Last updated
04/26/2010
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