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10025 South 705 Road Wyandotte OK 74370 | |
(918) 303-5433 | |
Not Available |
Full Name | |
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Speciality | Counselor - Addiction (substance Use Disorder) |
Location | 10025 South 705 Road, Wyandotte, Oklahoma |
Authorized Official Name and Position | Jessica Mullin (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 9183259837 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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22 N Eight Tribes Trl Miami OK 74354-1011 Ph: (918) 994-1819 | 10025 South 705 Road Wyandotte OK 74370 Ph: (918) 303-5433 |
NPI Number | 1265083380 |
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Provider Enumeration Date | 09/20/2019 |
Last Update Date | 06/07/2023 |
Certification Date | 06/07/2023 |
Identifier | Type | State | Issuer |
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1265083380 | NPI | - | NPPES |