TERRY LAKE

MIAMI, OK
NPI1760809180
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2014-03-24
Last Update Date2014-03-24
Business Address
-- TERRY LAKE
130 W STEVE OWENS BLVD
MIAMI, OK 74354-7629
Phone number: 918-542-2845
Mailing Address
-- TERRY LAKE
PO BOX 1271
MIAMI, OK 74355-1271
Phone number: 918-675-4100
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