Individual
MR. MICHAEL DEAN FLEETWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
1824 S VAN BUREN ST, ENID, OK 73703-7903
(580) 540-8965
Mailing address
2113 NE 15TH ST, MOORE, OK 73160-8625
(052) 038-5294
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
164
OK
Other
Enumeration date
11/18/2019
Last updated
11/18/2019
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