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1033423389
KEVIN ERNEST MELLENCAMP
LAWTON, OK
NPI
1033423389
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: OK 4005)
Enumeration Date
2010-07-28
Last Update Date
2010-07-28
Business Address
Mr. KEVIN ERNEST MELLENCAMP M.S. LPC
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505-5243
Phone number: 580-355-8883
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Mailing Address
Mr. KEVIN ERNEST MELLENCAMP M.S. LPC
1320 NW HOMESTEAD DR STE G
LAWTON, OK 73505-5243
Phone number: 580-355-8883
Copy
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