Individual
MR. LARRY ANNAISE BIRDEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3621 N KELLEY AVE, SUITE 100, OKLAHOMA CITY, OK 73111-4520
(405) 524-5525
Mailing address
305 BRACKENDALE LN, EDMOND, OK 73003-4747
(504) 251-1313
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/01/2011
Last updated
07/01/2011
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