| Doctor Name: | WOODSON LEE COPLEN |
| NPI Number: | 1073555405 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.ED., LMFT,LADC/MH |
| License Number: | 311 |
| Business Practice Address: | 420 N Kickapoo Ave Shawnee, OK - 748016643 |
| Business Phone Number: | 4056239017 |
| Business Fax Number: | 4052140933 |
| Mailing Address: | Po Box 1582, SHAWNEE |
| State: | OK |
| Postal Code: | 748021582 |
| Phone Number: | 4056239017 |
| Fax Number: | 4052140933 |
| NPI Enumeration Date: | 06/11/2006 |
| NPI Last Update Date: | 03/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 311 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OK |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |