Individual
KASSANDRA GOODALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
186 W COURT ST, ATOKA, OK 74525-1822
(580) 364-0669
(580) 364-0673
Mailing address
186 W COURT ST, ATOKA, OK 74525-1822
(580) 364-0669
(580) 364-0673
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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