NPI Profile for SANDY BOURGEOIS in ALTUS, OK.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Mental Health |
101YM0800X |
| NPI # | 1447269634 |
|
| Status | Active | |
| Credentials | LPC (Licensed Professional Counselor) | |
| Entity | Individual | |
| Enumeration date | 08/05/2006 | |
| Last updated | 04/23/2025 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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SANDY BOURGEOIS
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