Individual
MS. ANITA JOY CANTRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.DIV.
Contact information
Practice address
1520 NORTH INDUSTRIAL AVE, VINITA, OK 74301
(918) 256-7518
(918) 256-6771
Mailing address
BOX 912, VINITA, OK 74301
(918) 256-7518
(918) 256-6771
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100732380A
—
OK
05
—
100732380C
—
OK
05
—
100732380E
—
OK
05
—
100732380F
—
OK
Enumeration date
05/10/2013
Last updated
05/10/2013
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