| Doctor Name: | MARY DEGAND |
| NPI Number: | 1043528698 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | LPC 2838 |
| Business Practice Address: | 5050 Williams Ave Woodward, OK - 738017713 |
| Business Phone Number: | 5802569700 |
| Business Fax Number: | 5802569704 |
| Mailing Address: | 1222 10th St, Suite 211 WOODWARD |
| State: | OK |
| Postal Code: | 738013156 |
| Phone Number: | 5802569700 |
| Fax Number: | 5802569704 |
| NPI Enumeration Date: | 09/16/2010 |
| NPI Last Update Date: | 09/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LPC 2838 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |