Tyler Wade Goodman - Ponca City, OK

Tyler Wade Goodman

Peer Specialist in Ponca City, Oklahoma

NPI 1124884242

Tyler Wade Goodman is a Peer Specialist based in Ponca City, OK. Tyler Wade Goodman practices in Ponca City, OK. The NPI Number for Tyler Wade Goodman is 1124884242 and holds a License No. (Oklahoma).

The current practice location address for Tyler Wade Goodman is 93 Noel Ln, Ponca City, OK and can be reached out via phone at 580-485-5796.

Location: 93 Noel Ln, Ponca City, OK, 74604-5443

NPI Number

1124884242

Provider Name

Tyler Wade Goodman

Credential

Provider Entity Type

Individual

Gender

Male

Address

93 Noel Ln, Ponca City, OK, 74604-5443

Phone Number

580-485-5796

Fax Number

Provider Enumeration Date

02/26/2024

Last Update Date

04/14/2024

Address

93 Noel Ln

City

Ponca City

State

Oklahoma

Zip

74604-5443

Phone Number

580-485-5796

Fax Number

Address

93 Noel Ln

City

Ponca City

State

Oklahoma

Zip

74604-5443

Phone Number

580-485-5796

Fax Number

Type

Other Service Providers

Classification

Peer Specialist

Speciality

Taxonomy

175T00000X

License No.

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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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