Individual
CHANNELL MARIE HAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1219 K ST NW, ARDMORE, OK 73401-1801
(580) 798-4523
Mailing address
1219 K ST NW, ARDMORE, OK 73401-1801
(580) 504-7718
Taxonomy
Speciality
Code
Description
License number
State
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
Primary
—
OK
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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