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5350 S Western Ave Ste 734 Oklahoma City OK 73109-4535 | |
| (405) 776-9950 | |
| (877) 265-2920 |
| Full Name | |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5350 S Western Ave Ste 734, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Shylah K Ridgway (OWNER) |
| Authorized Official Contact | 4057769950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
218 Reiter Cir Enid OK 73701-6411 Ph: (405) 776-9950 | 5350 S Western Ave Ste 734 Oklahoma City OK 73109-4535 Ph: (405) 776-9950 |
| NPI Number | 1447095484 |
|---|---|
| Provider Enumeration Date | 07/01/2024 |
| Last Update Date | 02/04/2025 |
| Certification Date | 02/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447095484 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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