Individual
CARON AVERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 E 5TH ST, CLAREMORE, OK 74017-7415
(918) 849-1064
Mailing address
320 E 5TH ST, CLAREMORE, OK 74017-7415
(918) 849-1064
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
Other
Enumeration date
08/21/2016
Last updated
08/21/2016
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