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Individual

CONNIE DOCKREY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1605 N HARRISON ST # 1605, SHAWNEE, OK 74804-4022
(405) 481-7187
Mailing address
20082 OLD BARN RD, TECUMSEH, OK 74873-5647
(405) 250-5313

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200619400A
OK
Enumeration date
09/14/2015
Last updated
09/09/2022
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