Individual
MS. MARY CLAUCH WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
303 EAST COURT STREET, ATOKA, OK 74525-0251
(580) 239-2868
Mailing address
PO BOX 251, ATOKA, OK 74525-0251
(580) 239-2868
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101100000X
OK
Other
Enumeration date
08/07/2012
Last updated
08/05/2021
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