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Individual

MS. DANA K FITZGERALD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
12203 E 82ND PL N, OWASSO, OK 74055-6213
(772) 584-0464
Mailing address
12203 E 82ND PL N, OWASSO, OK 74055-6213
(772) 584-0464

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
101YM0800X
Mental Health Counselor

Other

Enumeration date
11/01/2011
Last updated
11/01/2011
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