Individual
DUSTY DOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12005 E 470 RD, CLAREMORE, OK 74017-3737
(918) 342-0770
(918) 342-0087
Mailing address
12005 E 470 RD, CLAREMORE, OK 74017-3737
(918) 342-0770
(918) 342-0087
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7612
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
05/27/2016
Last updated
09/11/2023
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