Individual
JAY CASEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S
Contact information
Practice address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
(580) 765-7299
Mailing address
620 W GRAND AVE, PONCA CITY, OK 74601-5123
(580) 762-1462
(580) 765-7299
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OK
Other
Enumeration date
05/31/2007
Last updated
07/08/2007
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