Individual
ANITA K SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, BHP
Contact information
Practice address
212 SE 1ST, PRYOR, OK 74361
(918) 825-4115
Mailing address
PO BOX 912, PRYOR, OK 74362-0912
(918) 825-4115
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
48
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100732380F
—
OK
Enumeration date
01/27/2010
Last updated
01/27/2010
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