MELISSA PROVENCE

IDABEL, OK
NPI1861075830
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2021-04-28
Last Update Date2021-04-28
Business Address
MELISSA PROVENCE
2000 E LINCOLN RD
IDABEL, OK 74745-7353
Phone number: 580-286-6639
Mailing Address
MELISSA PROVENCE
PO BOX 579
MCALESTER, OK 74502-0579
Phone number:
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