Individual
MRS. CAROL LYNN VANDIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1625 W GARRIOTT RD STE F, ENID, OK 73703-5653
(580) 242-4673
Mailing address
101 S JANE LN, ENID, OK 73703-5060
(580) 478-5650
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPCCANDIDATE13351
OK
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/23/2024
Last updated
08/05/2026
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