Individual
MICHAEL GARRETT DEGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MCP, LADC, LPC
Contact information
Practice address
200 WHITE EAGLE DR, PONCA CITY, OK 74601-8315
(580) 762-3421
(580) 762-3413
Mailing address
123 WHITE EAGLE DR, PONCA CITY, OK 74601-8307
(580) 762-3421
(580) 762-3413
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1354
OK
101YM0800X
Mental Health Counselor
7221
OK
Other
Enumeration date
06/16/2015
Last updated
11/08/2019
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