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Mr. Manote Prommart
Mental Health Counselor in Broken Arrow, Oklahoma
NPI 1619208063

Manote Prommart is a Mental Health Counselor based in Broken Arrow, OK and is specialized in Mental Health. Manote Prommart practices in Broken Arrow, OK. The NPI Number for Manote Prommart is 1619208063 and holds a License No. (Oklahoma).

The current practice location address for Manote Prommart is 1101 S 33Rd St, Broken Arrow, OK and can be reached out via phone at 918-497-8806.

Location: 1101 S 33Rd St, Broken Arrow, OK, 74014-2929
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1619208063
Provider Name
Manote Prommart
Credential
Provider Entity Type
Individual
Gender
Male
Address
1101 S 33Rd St, Broken Arrow, OK, 74014-2929
Phone Number
918-497-8806
Fax Number
Provider Enumeration Date
01/25/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100708360B 05 OK
institution
Provider Business Practice Location Address Details
Address
1101 S 33Rd St
City
Broken Arrow
State
Oklahoma
Zip
74014-2929
Phone Number
918-497-8806
Fax Number
person
Provider Business Mailing Address Details
Address
1101 S 33Rd St
City
Broken Arrow
State
Oklahoma
Zip
74014-2929
Phone Number
918-497-8806
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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