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1376829002
BENARD MAIRURA MANYIBE
EDMOND, OK
NPI
1376829002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2011-10-26
Last Update Date
2011-10-26
Business Address
Dr. BENARD MAIRURA MANYIBE LADC counselor
930 S BOULEVARD APT 208
EDMOND, OK 73034-4714
Phone number: 419-378-2485
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Mailing Address
Dr. BENARD MAIRURA MANYIBE LADC counselor
930 S BOULEVARD APT 208
EDMOND, OK 73034-4714
Phone number: 419-378-2485
Copy
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