Individual
JOSEPH ADDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2 N WATER ST, SAPULPA, OK 74066-2816
(918) 224-0225
Mailing address
19675 S 49TH WEST AVE, MOUNDS, OK 74047-4697
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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