Individual
ANTHONY ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
701 N PRAIRIE AVE, OKMULGEE, OK 74447-7616
(918) 237-7296
Mailing address
701 N PRAIRIE AVE, OKMULGEE, OK 74447-7616
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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