MARK CODY BANTA

MCLOUD, OK
NPI1013138965
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OK  04525)
Enumeration Date2007-05-01
Last Update Date2026-07-13
Business Address
Mr. MARK CODY BANTA LPC
105365 S.HWY 102
MCLOUD, OK 74851
Phone number: 405-988-2618
Mailing Address
Mr. MARK CODY BANTA LPC
43925 HUNTERS HILL DR
SHAWNEE, OK 74801-8927
Phone number: 405-988-2075
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