Individual
BROOK LADAWN CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 SW PENN, BARTLESVILLE, OK 74003
(918) 213-5407
Mailing address
700 SW PENN, BARTLESVILLE, OK 74003
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
175T00000X
Peer Specialist
130814
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000765770
—
OK
Enumeration date
06/01/2018
Last updated
04/10/2019
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