Pennington Creek Life House
NPI #1922246115 in Coalgate, Oklahoma
Provider Information
- NPI Number
- 1922246115
- Entity Type
- Organization
- Organization Name
- Pennington Creek Life House
- Primary Specialty
- Community/Behavioral Health
- Enumeration Date
- Jan 27, 2009
- Last Updated
- Jan 27, 2009
Practice Location
Authorized Official
- Name
- MRS. JAN M WYATT, MS LPC
- Title
- CLINICAL DIRECTOR
- Phone
- (580) 310-4164
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community/Behavioral Health |
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