Individual
SAMANTHA MASQUAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC/MH
Contact information
Practice address
1800 E MEMORIAL RD STE 102, OKLAHOMA CITY, OK 73131-1827
(405) 625-1665
Mailing address
3317 MEADOW LN, EDMOND, OK 73013-5420
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
1334
—
Other
Enumeration date
05/22/2017
Last updated
08/04/2020
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