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1366918914
GERTRUDE GRACE HAYNES
WAGONER, OK
NPI
1366918914
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-10-22
Last Update Date
2018-10-22
Business Address
GERTRUDE GRACE HAYNES
2109 S HIGHWAY 69
WAGONER, OK 74467-9310
Phone number: 918-708-3006
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Mailing Address
GERTRUDE GRACE HAYNES
2109 S HIGHWAY 69
WAGONER, OK 74467-9310
Phone number: 918-708-3006
Copy
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