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Individual

MR. FRED LEE MCGINN IV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
14836 GAMBELS TRAIL DR, OKLAHOMA CITY, OK 73134-5226
(405) 509-5056
Mailing address
14836 GAMBELS TRAIL DR, OKLAHOMA CITY, OK 73134-5226
(405) 509-5056

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4800
OK
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
1003
OK

Other

Enumeration date
05/17/2010
Last updated
05/11/2026
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