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Individual

CHARLES CORBIN HUMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, LPC

Contact information

Practice address
3908 N PENIEL AVE STE 500, BETHANY, OK 73008-3402
(405) 808-7180
Mailing address
3908 N PENIEL AVE STE 500, BETHANY, OK 73008-3402
(405) 808-7180

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3981
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200318120A
OK
05
200318120B
OK
Enumeration date
04/08/2010
Last updated
07/04/2019
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