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Anthony Dirteater
Peer Specialist in Tahlequah, Oklahoma
NPI 1265202659

Anthony Dirteater is a Peer Specialist based in Tahlequah, OK. Anthony Dirteater practices in Tahlequah, OK. The NPI Number for Anthony Dirteater is 1265202659 and holds a License No. (Oklahoma).

The current practice location address for Anthony Dirteater is 113 W Keetoowah St, Tahlequah, OK and can be reached out via phone at 918-931-3700.

Location: 113 W Keetoowah St, Tahlequah, OK, 74464-3819
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1265202659
Provider Name
Anthony Dirteater
Credential
Provider Entity Type
Individual
Gender
Male
Address
113 W Keetoowah St, Tahlequah, OK, 74464-3819
Phone Number
918-931-3700
Fax Number
Provider Enumeration Date
01/05/2024
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
113 W Keetoowah St
City
Tahlequah
State
Oklahoma
Zip
74464-3819
Phone Number
918-931-3700
Fax Number
person
Provider Business Mailing Address Details
Address
113 W Keetoowah St
City
Tahlequah
State
Oklahoma
Zip
74464-3819
Phone Number
918-931-3700
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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