SHELLY J LARSON

MANGUM, OK
NPI1891902409
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK  256)
Enumeration Date2007-05-16
Last Update Date2007-07-08
Business Address
Mr. SHELLY J LARSON CADC
2 WICKERSHAM ST
MANGUM, OK 73554-9117
Phone number: 580-782-3337
Mailing Address
Mr. SHELLY J LARSON CADC
2 WICKERSHAM ST
MANGUM, OK 73554-9117
Phone number: 580-782-3337
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