Individual
AMBER DETAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4130 N LINCOLN BLVD, OKLAHOMA CITY, OK 73105-5209
(405) 424-7711
Mailing address
937 N ROCKWELL AVE APT 64, OKLAHOMA CITY, OK 73127-5326
(405) 408-0633
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
04/13/2022
Last updated
04/02/2025
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