Individual
DR. DUSTIN GANT WARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1044 SW 4TH ST, MOORE, OK 73160-2405
(405) 735-6333
(405) 735-6629
Mailing address
1044 SW 4TH ST, MOORE, OK 73160-2405
(405) 735-6333
(405) 735-6629
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
1011
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200075530 B
—
OK
05
—
200075530 C
—
OK
Enumeration date
06/06/2006
Last updated
05/29/2015
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