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Mr. Stanley Large III
Peer Specialist in Lawton, Oklahoma
NPI 1205695210

Stanley Large III is a Peer Specialist based in Lawton, OK. Stanley Large III practices in Lawton, OK. The NPI Number for Stanley Large III is 1205695210 and holds a License No. (Oklahoma).

The current practice location address for Stanley Large III is 1307 Sw Washington Ave, Lawton, OK and can be reached out via phone at 580-355-7500.

Location: 1307 Sw Washington Ave, Lawton, OK, 73501-7231
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205695210
Provider Name
Stanley Large III
Credential
Provider Entity Type
Individual
Gender
Male
Address
1307 Sw Washington Ave, Lawton, OK, 73501-7231
Phone Number
580-355-7500
Fax Number
Provider Enumeration Date
03/14/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
1307 Sw Washington Ave
City
Lawton
State
Oklahoma
Zip
73501-7231
Phone Number
580-355-7500
Fax Number
person
Provider Business Mailing Address Details
Address
1307 Sw Washington Ave
City
Lawton
State
Oklahoma
Zip
73501-7231
Phone Number
580-355-7500
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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