Individual
QUENTIN JAMELLE CHANEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
10948 N MAY AVE STE B, OKLAHOMA CITY, OK 73120-6224
(405) 751-8889
Mailing address
3825 24TH AVE SE, APT 6, NORMAN, OK 73071-1770
(918) 852-5005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200287120A
—
OK
Enumeration date
01/11/2013
Last updated
01/11/2013
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