Mystic D Crenshaw
NPI #1366740680 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1366740680
- Entity Type
- Individual
- Name
- Mystic D Crenshaw
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor
- Enumeration Date
- Mar 10, 2011
- Last Updated
- Mar 10, 2011
Practice Location
- Address
- 3100 S ELM PL STE B
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-7950
- Phone
- (918) 286-2535
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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