Individual
MRS. CATRINA BLAISE CANTWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
620 NW 5TH ST STE D, MOORE, OK 73160-3947
(405) 208-4469
(405) 208-4472
Mailing address
620 NW 5TH ST STE D, MOORE, OK 73160-3947
(405) 208-4469
(405) 208-4472
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
11302
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201133840A
—
OK
Enumeration date
06/08/2020
Last updated
08/15/2023
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