Individual
MATHEW SEAN VILLINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1010 E 45TH ST, SHAWNEE, OK 74804-2202
(405) 380-3502
Mailing address
2132 IDEAL ST, SEMINOLE, OK 74868-2140
(405) 380-3502
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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