person
Raven Jacinda Wall, CADCUNDERSUPERVISI
Addiction (Substance Use Disorder) Counselor in Norman, Oklahoma
NPI 1457524027

Raven Jacinda Wall is an Addiction (Substance Use Disorder) Counselor based in Norman, OK and is specialized in Addiction (Substance Use Disorder). Raven Jacinda Wall practices in Norman, OK and has the professional credentials of CADCUNDERSUPERVISI. The NPI Number for Raven Jacinda Wall is 1457524027 and holds a License No. (Oklahoma).

The current practice location address for Raven Jacinda Wall is 2920 Chautauqua Ave Apt 38, Norman, OK and can be reached out via phone at 405-528-8686 and via fax at 405-528-8692.

Location: 2920 Chautauqua Ave Apt 38, Norman, OK, 73072-7736
person
Provider Profile Details
NPI Number
1457524027
Provider Name
Raven Jacinda Wall
Credential
CADCUNDERSUPERVISI
Provider Entity Type
Individual
Gender
Female
Address
2920 Chautauqua Ave Apt 38, Norman, OK, 73072-7736
Phone Number
405-528-8686
Fax Number
405-528-8692
Provider Enumeration Date
04/03/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2920 Chautauqua Ave Apt 38
City
State
Zip
73072-7736
Phone Number
405-528-8686
Fax Number
405-528-8692
person
Provider Business Mailing Address Details
Address
2920 Chautauqua Ave Apt 38
City
State
Zip
73072-7736
Phone Number
405-528-8686
Fax Number
405-528-8692
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
(Oklahoma)
Definition
Definition to come...
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