Doctor Name: | NORMA C COBB |
NPI Number: | 1376664136 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | C.A.D.C. |
License Number: | # 176 |
Business Practice Address: | 109 S Harrill Ave Wagoner, OK - 744675317 |
Business Phone Number: | 9184853554 |
Business Fax Number: | |
Mailing Address: | 205 N Filmore Ave, # 302 WAGONER |
State: | OK |
Postal Code: | 744674111 |
Phone Number: | 9182076255 |
Fax Number: | |
NPI Enumeration Date: | 04/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | # 176 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |