Providence Service Corporation

NPI #1821003658 in Lawton, Oklahoma

Provider Information

NPI Number
1821003658
Entity Type
Organization
Organization Name
Providence Service Corporation
Primary Specialty
Public Health or Welfare
Enumeration Date
Jul 30, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
4645 W GORE BLVD
Address 2
SUITE 5
City
Lawton
ZIP Code
73505-6041
Phone
(580) 355-6800

Authorized Official

Name
MS. AGLAIA 'ALEXIS' MARTIN, LPC
Title
THERAPIST
Phone
(580) 355-6800

Specialties & Taxonomy Codes

Specialty
Public Health or Welfare

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