James Ellis Bohannon, M.S.B.S.
Counselor in Lawton, OK. Individual provider (NPI-1).
NPI number1487053898
StatusActive
Last updated in NPPESAug 21, 2014
Details
- NPI
- 1487053898
- Entity type
- Individual (NPI-1)
- Name
- James Ellis Bohannon
- Credential
- M.S.B.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 21, 2014
- Last updated
- Aug 21, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | – | – | Yes |
Practice location
601 Sw B AveLawton, OK 73501-3907
Phone 580-214-0244
Mailing address
6121 Sw Park PlLawton, OK 73505-7731
Phone 619-341-2413
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