DIANA LYNN LIVELY

TAHLEQUAH, OK
NPI1477892925
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2013-02-04
Last Update Date2013-02-04
Business Address
-- DIANA LYNN LIVELY MS
109 W 2ND ST
TAHLEQUAH, OK 74464-4723
Phone number: 918-431-0418
Mailing Address
-- DIANA LYNN LIVELY MS
14966 W GRANDVIEW RD
TAHLEQUAH, OK 74464-1120
Phone number: 918-931-1971
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