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1912141813
MARVIN RAY BRACE
STILLWATER, OK
NPI
1912141813
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 161)
Enumeration Date
2009-04-23
Last Update Date
2009-04-23
Business Address
Mr. MARVIN RAY BRACE CADC
217 W 5TH AVE STE 7
STILLWATER, OK 74074-4056
Phone number: 405-743-1968
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Mailing Address
Mr. MARVIN RAY BRACE CADC
217 W 5TH AVE STE 7
STILLWATER, OK 74074-4056
Phone number: 405-743-1968
Copy
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