Individual
MRS. DANA JUAREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMFT
Contact information
Practice address
220 N MAIN ST, C/O 300 N MAIN, ALTUS, OK 73521-7352
(580) 482-0230
Mailing address
220 N MAIN ST, C/O 300 N MAIN ST, ALTUS, OK 73521
(843) 476-8385
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1350
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100739030A
—
OK
Enumeration date
12/16/2014
Last updated
07/30/2024
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