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Individual

CHANDRA LONE WOLF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LMSW-P

Contact information

Practice address
105365 S HIGHWAY 102, MCLOUD, OK 74851-3051
(405) 964-2618
Mailing address
PO BOX 1059, MCLOUD, OK 74851-1059
(405) 964-2618

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary

Other

Enumeration date
11/07/2019
Last updated
11/07/2019
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