Individual
MR. RODNEY BLAKE CARGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
730 W WILSHIRE BLVD STE 114, OKLAHOMA CITY, OK 73116-7738
(405) 922-7750
Mailing address
700 SAGE BRUSH RD, YUKON, OK 73099-6870
(405) 922-7750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
104100000X
Social Worker
10027
OK
Other
Enumeration date
09/02/2010
Last updated
07/13/2012
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