Individual
MR. EDWARD RYAN PENSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., LPC
Contact information
Practice address
603 S 1ST ST, MADILL, OK 73446-3807
(580) 795-5564
Mailing address
13901 W GREASY BEND RD, MANNSVILLE, OK 73447-1023
(580) 222-6905
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3815
OK
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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