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1720303134
JOSEPH ROBERT EATHERLY
TISHOMINGO, OK
NPI
1720303134
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OK 5004)
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2010-03-30
Last Update Date
2017-08-16
Business Address
Mr. JOSEPH ROBERT EATHERLY LPC
108 W MAIN ST
TISHOMINGO, OK 73460-1723
Phone number: 580-371-3019
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Mailing Address
Mr. JOSEPH ROBERT EATHERLY LPC
49500 CR E 1600
STRATFORD, OK 74872
Phone number: 580-320-5633
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