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Allegra Riley Desiree Birdwell
Peer Specialist in Vinita, Oklahoma
NPI 1104523844

Allegra Riley Desiree Birdwell is a Peer Specialist based in Vinita, OK. Allegra Riley Desiree Birdwell practices in Vinita, OK. The NPI Number for Allegra Riley Desiree Birdwell is 1104523844 and holds a License No. (Oklahoma).

The current practice location address for Allegra Riley Desiree Birdwell is 405 E Excelsior Ave, Vinita, OK and can be reached out via phone at 918-256-6476.

Location: 405 E Excelsior Ave, Vinita, OK, 74301-4226
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104523844
Provider Name
Allegra Riley Desiree Birdwell
Credential
Provider Entity Type
Individual
Gender
Female
Address
405 E Excelsior Ave, Vinita, OK, 74301-4226
Phone Number
918-256-6476
Fax Number
Provider Enumeration Date
02/13/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
405 E Excelsior Ave
City
Vinita
State
Oklahoma
Zip
74301-4226
Phone Number
918-256-6476
Fax Number
person
Provider Business Mailing Address Details
Address
405 E Excelsior Ave
City
Vinita
State
Oklahoma
Zip
74301-4226
Phone Number
918-256-6476
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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