Individual
JOHN WITOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
1325 E BOONE ST, TAHLEQUAH, OK 74464-3361
(918) 207-4977
Mailing address
22727 S 540 RD, TAHLEQUAH, OK 74464
(918) 207-4977
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1228
OK
Other
Enumeration date
10/18/2010
Last updated
01/14/2016
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