Individual
MR. CLIFFORD DWAIN SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC/LADC
Contact information
Practice address
214 E OAK AVE, SEMINOLE, OK 74868-3442
(405) 382-1112
Mailing address
24198 BRANGUS RD, TECUMSEH, OK 74873-7520
(405) 598-1761
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
798
OK
101YM0800X
Mental Health Counselor
Primary
2874
OK
Other
Enumeration date
01/03/2013
Last updated
09/19/2014
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