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1326249640
DONNA LONGBRAKE
PONCA CITY, OK
NPI
1326249640
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-05-31
Last Update Date
2007-07-08
Business Address
-- DONNA LONGBRAKE B.S.
620 W GRAND AVE
PONCA CITY, OK 74601-5123
Phone number: 580-762-1462
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Mailing Address
-- DONNA LONGBRAKE B.S.
620 W GRAND AVE
PONCA CITY, OK 74601-5123
Phone number: 580-762-1462
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