Individual
MARISA MANSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 S GIN RD, ATOKA, OK 74525-7348
(580) 889-3399
Mailing address
PO BOX 205, STRINGTOWN, OK 74569-0205
(580) 513-1622
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
Other
Enumeration date
01/13/2015
Last updated
01/13/2015
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