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926 W Willow Ave Duncan OK 73533-4922 | |
| (580) 467-8906 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 926 W Willow Ave, Duncan, Oklahoma |
| Authorized Official Name and Position | Dorothy Susan Denard (OWNER) |
| Authorized Official Contact | 5804678906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
926 W Willow Ave Duncan OK 73533-4922 Ph: (580) 467-8906 | 926 W Willow Ave Duncan OK 73533-4922 Ph: (580) 467-8906 |
| NPI Number | 1114234234 |
|---|---|
| Provider Enumeration Date | 09/10/2010 |
| Last Update Date | 09/10/2010 |
| Medicare PECOS PAC ID | 1658815527 |
|---|---|
| Medicare Enrollment ID | O20240702002952 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114234234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 4076 (Oklahoma) | Primary |
| Provider Name | Dorothy Susan Denard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255571899 PECOS PAC ID: 0648620054 Enrollment ID: I20231227003341 |
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