Individual
MR. WAYNE F. DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LADC
Contact information
Practice address
5131 N CLASSEN BLVD, SUITE 110, OKLAHOMA CITY, OK 73118-5258
(405) 767-1126
Mailing address
1920 FOUNTAIN VW, EDMOND, OK 73013-2618
(405) 348-6349
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2800
OK
Other
Enumeration date
06/09/2007
Last updated
07/08/2007
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