Individual
MELISSA ANN MCDARIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
706 SW 3RD ST, WAGONER, OK 74467-5515
(918) 485-6206
(918) 485-1709
Mailing address
703 S.W. 3RD ST., WAGONER, OK 74467
(918) 698-7134
(918) 485-1709
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YP2500X
Professional Counselor
5299
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200366010B
—
OK
Enumeration date
03/02/2007
Last updated
03/23/2022
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