Individual
JOHN PHILLIP STONE SCOGGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 CANTERBURY LANE, IDABEL, OK 74745
(918) 237-8612
Mailing address
111 CANTERBURY LANE, IDABEL, OK 74745
(918) 237-8612
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
STONE1010
—
OK
Enumeration date
07/19/2013
Last updated
07/19/2013
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