Doctor Name: | MR. CHAD IRVIN YORK |
NPI Number: | 1811375306 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 33200 S 625 Rd Jay, OK - 743465398 |
Business Phone Number: | 9184189185 |
Business Fax Number: | |
Mailing Address: | Po Box 129, BIG CABIN |
State: | OK |
Postal Code: | 743320129 |
Phone Number: | 9184189185 |
Fax Number: | |
NPI Enumeration Date: | 05/15/2015 |
NPI Last Update Date: | 05/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |