BRANDI D DETHEROW

SAPULPA, OK
NPI1538387410
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: OK  none)
Enumeration Date2007-04-23
Last Update Date2007-07-08
Business Address
Mrs. BRANDI D DETHEROW LCSW provisional
15 E DEWEY AVE
SAPULPA, OK 74066-4201
Phone number: 918-227-2016
Mailing Address
Mrs. BRANDI D DETHEROW LCSW provisional
832 W COMMERCIAL ST.
BROKEN ARROW, OK 74012
Phone number: 918-607-3444