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Individual

PAIGE ANDERSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2379 E 140TH ST S, BIXBY, OK 74008-4844
(918) 752-8239
Mailing address
2379 E 140TH ST S, BIXBY, OK 74008-4844
(918) 752-8239

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
175T00000X
Peer Specialist
Primary

Other

Enumeration date
10/12/2022
Last updated
11/21/2022
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