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1679881361
MICKI MELINDA FOUSE
ANTLERS, OK
NPI
1679881361
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2010-09-16
Last Update Date
2010-09-16
Business Address
-- MICKI MELINDA FOUSE
608 HIGHWAY 271 N
ANTLERS, OK 74523-2055
Phone number: 580-298-5062
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Mailing Address
-- MICKI MELINDA FOUSE
RR 2 BOX 989
VALLIANT, OK 74764-9761
Phone number: 580-298-5062
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