Individual
MRS. LISA VANTRIEST-PEADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2100 N BROADWAY AVE, ADA, OK 74820-1048
(580) 436-7120
(580) 436-7121
Mailing address
2100 N BROADWAY AVE, ADA, OK 74820-1048
(580) 436-7120
(580) 436-7121
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2965
OK
Other
Enumeration date
06/23/2006
Last updated
12/22/2008
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