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Individual

MRS. ASHLEY NICOLE FERGUSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS IN SOCIAL WORK

Contact information

Practice address
1095 NICKERSON ST, WAYNOKA, OK 73860-1252
(580) 824-0674
(580) 824-0676
Mailing address
PO BOX 135, WAYNOKA, OK 73860-0135
(580) 824-0674
(580) 824-0676

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
299
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
299
OK. BRD OF LIC. AOD COUN
OK
Enumeration date
03/15/2007
Last updated
07/08/2007
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