Individual
DEREK JAMES WAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10317 GREENBRIAR PL, SUITE 200, OKLAHOMA CITY, OK 73159-7651
(405) 464-6393
Mailing address
3100 S RANKIN ST, EDMOND, OK 73013-5354
(405) 464-6393
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OK
103K00000X
Behavior Analyst
—
OK
Other
Enumeration date
02/09/2011
Last updated
02/29/2016
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