Individual
MRS. PHILISHA J AUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CADC
Contact information
Practice address
13597 SE 202ND RD, TALIHINA, OK 74571-6003
(918) 567-2905
(918) 567-2995
Mailing address
PO BOX 185, CLAYTON, OK 74536-0185
(918) 567-2905
(918) 567-2995
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
322
OK
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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