Individual
MR. JOSEPH WILLIAM TELKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPS, LPC, UNDER SUP
Contact information
Practice address
1107 E 13TH ST, GROVE, OK 74344-7955
(918) 787-8744
Mailing address
1705 HEBBERT ST, GROVE, OK 74344-2700
(573) 944-3838
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100734620-B
—
OK
05
—
100734620-D
—
OK
Enumeration date
04/20/2007
Last updated
03/24/2011
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