Doctor Name: | MR. MARK B WESTFALL |
NPI Number: | 1346555463 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CADC, BHRS |
License Number: | 314 |
Business Practice Address: | 1115 Harber Rd. Grove, OK - 74344 |
Business Phone Number: | 9187864434 |
Business Fax Number: | 9187875985 |
Mailing Address: | Po Box 451385, GROVE |
State: | OK |
Postal Code: | 743451385 |
Phone Number: | 9187864434 |
Fax Number: | 9187864435 |
NPI Enumeration Date: | 08/12/2010 |
NPI Last Update Date: | 09/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 314 |
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: |