Individual
ALICIA CHASTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1301 7TH AVE NW, ARDMORE, OK 73401-2469
(580) 224-7215
Mailing address
1301 7TH AVE NW, ARDMORE, OK 73401-2469
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/04/2015
Last updated
02/04/2015
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