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Individual

DANE BEAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5812 NW 83RD ST, OKLAHOMA CITY, OK 73132-4916
(405) 831-3082
Mailing address
2233 NW 54TH ST, OKLAHOMA CITY, OK 73112-7714

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1700180
OK
171M00000X
Case Manager/Care Coordinator

Other

Enumeration date
02/19/2020
Last updated
10/06/2022
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