Individual
DOROTHY MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, LADC
Contact information
Practice address
107 S HIGH ST, ANTLERS, OK 74523-3818
(580) 298-2830
Mailing address
PO BOX 1030, ANTLERS, OK 74523-1030
(580) 298-2830
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3036
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200366040A
—
OK
Enumeration date
04/26/2007
Last updated
02/27/2020
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