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Travis Lee Woolridge
Peer Specialist in Wagoner, Oklahoma
NPI 1407500788

Travis Lee Woolridge is a Peer Specialist based in Broken Arrow, OK. Travis Lee Woolridge practices in Wagoner, OK. The NPI Number for Travis Lee Woolridge is 1407500788 and holds a License No. (Oklahoma).

The current practice location address for Travis Lee Woolridge is 109 S Harrill Ave, Wagoner, OK and can be reached out via phone at 573-473-7504.

Location: 109 S Harrill Ave, Wagoner, OK, 74014-4752
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407500788
Provider Name
Travis Lee Woolridge
Credential
Provider Entity Type
Individual
Gender
Male
Address
109 S Harrill Ave, Wagoner, OK, 74014-4752
Phone Number
573-473-7504
Fax Number
Provider Enumeration Date
02/07/2022
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
573-473-7504
Fax Number
person
Provider Business Mailing Address Details
Address
109 S Harrill Ave
City
Wagoner
State
Oklahoma
Zip
74467-5317
Phone Number
573-473-7504
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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