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Individual

CHRISTIAN EVERSOLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7777 E US RT 66, EL RENO, OK 73036
(352) 494-7837
Mailing address
7777 E US RT 66, EL RENO, OK 73036
(352) 494-7837

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1478
OK
175T00000X
Peer Specialist

Other

Enumeration date
02/04/2021
Last updated
11/22/2024
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