Individual
VICTORIA DILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBP,LPC,LADC
Contact information
Practice address
12306 S 13TH ST E, WARNER, OK 74469-8010
(918) 441-7775
(918) 989-5544
Mailing address
12306 S 13TH ST E, WARNER, OK 74469-8010
(918) 441-7775
(918) 989-5544
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
29
OK
101YP2500X
Professional Counselor
3071
OK
103TC1900X
Counseling Psychologist
Primary
0051
OK
Other
Enumeration date
04/24/2013
Last updated
04/24/2013
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