Organization
SEQUELCARE OF OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOROTHY METCALF MSW, LCSW, LADC (EXEC DIR)
(580) 298-2830
Entity
Organization
Contact information
Practice address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
Mailing address
PO BOX 1030, ANTLERS, OK 74523-1030
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
731465316
CLINICIAN3
OK
Enumeration date
04/27/2007
Last updated
12/31/2012
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