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1255617015
MYLINDA RENEE FANJ
WAGONER, OK
NPI
1255617015
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OK (us) 966)
Enumeration Date
2011-10-25
Last Update Date
2011-10-25
Business Address
-- MYLINDA RENEE FANJ M.S., LPC (us)
109 S HARRILL AVE
WAGONER, OK 74467-5317
Phone number: 918-485-3554
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Mailing Address
-- MYLINDA RENEE FANJ M.S., LPC (us)
109 S HARRILL AVE
WAGONER, OK 74467-5317
Phone number: 918-485-3554
Copy
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