Organization
ENID COUNSELING AND DIAGNOSTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL MARIE ROGGOW (BHRS)
(580) 242-5544
Entity
Organization
Contact information
Practice address
230 W MAPLE AVE, ENID, OK 73701-4012
(580) 242-5544
Mailing address
230 W MAPLE AVE, ENID, OK 73701-4012
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
OK
Other
Enumeration date
10/10/2012
Last updated
10/10/2012
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