Individual
MS. PATRICIA ANN MARIE HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, CM
Contact information
Practice address
1608 N. MAIN ST., TONKAWA, OK 74653
(580) 628-2539
(580) 628-4316
Mailing address
P.O. BOX 369, TONKAWA, OK 74653
(580) 628-2539
(580) 628-4316
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
924
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
04/10/2007
Last updated
03/01/2012
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