Individual
PETER MATTHEW MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2821 MUSTANG TRL, EDMOND, OK 73012-6688
(405) 859-5336
Mailing address
2821 MUSTANG TRL, EDMOND, OK 73012-6688
(405) 420-6522
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
08/21/2024
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