Provider Demographics
NPI:1952637480
Name:LAWRENSON, MARK (BHRS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:LAWRENSON
Suffix:
Gender:M
Credentials:BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 E JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:HUGO
Mailing Address - State:OK
Mailing Address - Zip Code:74743-4229
Mailing Address - Country:US
Mailing Address - Phone:580-326-7400
Mailing Address - Fax:
Practice Address - Street 1:1213 E JACKSON ST
Practice Address - Street 2:
Practice Address - City:HUGO
Practice Address - State:OK
Practice Address - Zip Code:74743-4229
Practice Address - Country:US
Practice Address - Phone:580-326-7400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-18
Last Update Date:2009-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health