Individual
CAMERON VONWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
115 S MAIN ST, NOBLE, OK 73068-9622
(405) 872-8461
Mailing address
115 S MAIN ST, NOBLE, OK 73068-9622
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200561790B
—
OK
Enumeration date
12/22/2020
Last updated
12/22/2020
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