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General NPI Number Information
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NPI Number | 1447403878
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Entity Type | Individual
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Provider Name | CHRISTINE MARIE EUBANKS MS, CBT. LPC
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Gender | Female
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Dates
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Enumeration Date | 10/29/2008
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 204 E CHOCTAW AVE
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City | SALLISAW
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State | OK
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Zip | 74955-4604
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Country | US
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Telephone | 918-790-2292
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Fax | 918-790-2291
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Provider Business Mailing Address
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Address Line | 111047 S 4700 RD
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City | MULDROW
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State | OK
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Zip | 74948-6812
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Country | US
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Telephone | 918-510-1873
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3850
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License Number State | OK
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