State of Oklahoma
NPI #1750456588 in Woodward, Oklahoma
Provider Information
- NPI Number
- 1750456588
- Entity Type
- Organization
- Organization Name
- State of Oklahoma
- Primary Specialty
- Clinic/Center - Medical Specialty
- Enumeration Date
- Nov 20, 2006
- Last Updated
- Mar 24, 2022
Practice Location
Authorized Official
- Name
- AUTUMN NICKELSON, LADC/LCSW
- Title
- EXECUTIVE DIRECTOR
- Phone
- (580) 571-3231
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
| Clinic/Center - Medical Specialty — Medical Specialty |
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