| Doctor Name: | JGUADALUPE SALGADO ANDRADE |
| NPI Number: | 1306138359 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | B.S. |
| License Number: | |
| Business Practice Address: | 209 W Broadway St Okemah, OK - 748592618 |
| Business Phone Number: | 9186232922 |
| Business Fax Number: | |
| Mailing Address: | 37084 Highway 19, PAULS VALLEY |
| State: | OK |
| Postal Code: | 730758678 |
| Phone Number: | 4052070591 |
| Fax Number: | 4052382084 |
| NPI Enumeration Date: | 05/10/2011 |
| NPI Last Update Date: | 05/17/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |