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Individual

MRS. DACIA RAYN NOVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
408 SE 5TH ST, PRYOR, OK 74361-6219
(918) 269-6745
Mailing address
408 SE 5TH ST, PRYOR, OK 74361-6219
(918) 269-6745

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
175T00000X
Peer Specialist
Primary
1538881347
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05181996
SELF
OK
Enumeration date
09/19/2022
Last updated
05/11/2026
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