Doctor Name: | EMILY CHILDERS |
NPI Number: | 1952682072 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 4080 |
Business Practice Address: | 715 Grandview Ave Pawhuska, OK - 740563201 |
Business Phone Number: | 9182879311 |
Business Fax Number: | |
Mailing Address: | 1300 De Soto St, PONCA CITY |
State: | OK |
Postal Code: | 746044001 |
Phone Number: | 9182929590 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2011 |
NPI Last Update Date: | 12/15/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 4080 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |