| Full Life Family Resource Center | |
|
205 Main St Broken Bow OK 74728-3975 | |
| (580) 584-2478 | |
| Not Available |
| Full Name | Full Life Family Resource Center |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 205 Main St, Broken Bow, Oklahoma |
| Authorized Official Name and Position | Glynis Watkins Daniel (OWNER) |
| Authorized Official Contact | 5805842478 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Life Family Resource Center Rr 2 Box 6090 Broken Bow OK 74728-9808 Ph: (580) 236-2376 | Full Life Family Resource Center 205 Main St Broken Bow OK 74728-3975 Ph: (580) 584-2478 |
| NPI Number | 1629334388 |
|---|---|
| Provider Enumeration Date | 04/06/2012 |
| Last Update Date | 04/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629334388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 3881 (Oklahoma) | Primary |
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