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Diana Lynn Lively, MS
Addiction (Substance Use Disorder) Counselor in Tahlequah, Oklahoma
NPI 1477892925

Diana Lynn Lively is an Addiction (Substance Use Disorder) Counselor based in Tahlequah, OK and is specialized in Addiction (Substance Use Disorder). Diana Lynn Lively practices in Tahlequah, OK and has the professional credentials of MS. The NPI Number for Diana Lynn Lively is 1477892925 and holds a License No. (Oklahoma).

The current practice location address for Diana Lynn Lively is 109 W 2Nd St, Tahlequah, OK and can be reached out via phone at 918-431-0418.

Location: 109 W 2Nd St, Tahlequah, OK, 74464-1120
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1477892925
Provider Name
Diana Lynn Lively
Credential
MS
Provider Entity Type
Individual
Gender
Female
Address
109 W 2Nd St, Tahlequah, OK, 74464-1120
Phone Number
918-431-0418
Fax Number
Provider Enumeration Date
02/04/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
109 W 2Nd St
City
Tahlequah
State
Oklahoma
Zip
74464-4723
Phone Number
918-431-0418
Fax Number
person
Provider Business Mailing Address Details
Address
109 W 2Nd St
City
Tahlequah
State
Oklahoma
Zip
74464-4723
Phone Number
918-431-0418
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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