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Madison M Medlock
Counselor in Wagoner, Oklahoma
NPI 1053976928

Madison M Medlock is a Counselor based in Wagoner, OK. Madison M Medlock practices in Wagoner, OK. The NPI Number for Madison M Medlock is 1053976928 and holds a License No. (Oklahoma).

The current practice location address for Madison M Medlock is 109 S Harrill Ave, Wagoner, OK and can be reached out via phone at 918-485-0242 and via fax at 918-485-0242.

Location: 109 S Harrill Ave, Wagoner, OK, 74467-5317
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053976928
Provider Name
Madison M Medlock
Credential
Provider Entity Type
Individual
Gender
Male
Address
109 S Harrill Ave, Wagoner, OK, 74467-5317
Phone Number
918-485-0242
Fax Number
918-485-0242
Provider Enumeration Date
05/07/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
109 S Harrill Ave
City
Wagoner
State
Oklahoma
Zip
74467-5317
Phone Number
918-485-0242
Fax Number
918-485-0242
person
Provider Business Mailing Address Details
Address
109 S Harrill Ave
City
Wagoner
State
Oklahoma
Zip
74467-5317
Phone Number
918-485-0242
Fax Number
918-485-0242
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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