Individual
HENI AZZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
69 ARROWHEAD LOOP, CANADIAN, OK 74425-5012
(935) 995-1697
Mailing address
69 ARROWHEAD LOOP, CANADIAN, OK 74425-5012
(935) 995-1697
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/03/2022
Last updated
10/03/2022
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