Individual
STAC EMBRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3321 N. MCKINLEY AVE, OKLAHOMA CITY, OK 73118
(405) 602-2022
Mailing address
3321 N MCKINLEY AVE, OKLAHOMA CITY, OK 73118-3439
(405) 602-2022
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/08/2014
Last updated
07/08/2014
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