Organization
SHELTERED WORK ACTIVITY PROGRAM INC
Active
Other names
SWAP
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD B BREEN PHD (CEO)
(918) 683-8162
Entity
Organization
Contact information
Practice address
210 E OKMULGEE ST, MUSKOGEE, OK 74403-5453
(918) 683-8162
(918) 687-5368
Mailing address
210 E OKMULGEE ST, MUSKOGEE, OK 74403-5453
(918) 683-8162
(918) 687-5368
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100682680B
—
OK
Enumeration date
08/30/2007
Last updated
08/14/2008
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