Prodigy Foundation
NPI #1700928603 in Tahlequah, Oklahoma
Provider Information
- NPI Number
- 1700928603
- Entity Type
- Organization
- Organization Name
- Prodigy Foundation
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Feb 14, 2007
- Last Updated
- Aug 22, 2020
Practice Location
Authorized Official
- Name
- MR. BARRY B. AVERETT
- Title
- OFFICE MANAGER
- Phone
- (918) 456-8399
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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