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1760683031
DELBERT SHIRLEY
PONCA CITY, OK
NPI
1760683031
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2007-05-31
Last Update Date
2012-11-20
Business Address
DELBERT SHIRLEY B.S.
620 W GRAND AVE
PONCA CITY, OK 74601-5123
Phone number: 580-762-1462
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Mailing Address
DELBERT SHIRLEY B.S.
620 W GRAND AVE
PONCA CITY, OK 74601-5123
Phone number: 580-762-1462
Copy
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