Individual
MR. CECIL OSTERDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, BHRS,CM
Contact information
Practice address
104 NE AVE A, IDABEL, OK 74745-3813
(580) 286-3301
(580) 286-6385
Mailing address
PO BOX 689, IDABEL, OK 74745-0689
(580) 286-3301
(580) 286-6385
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/16/2011
Last updated
11/30/2011
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