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Mr. Corwin John Ataddlety
Peer Specialist in Anadarko, Oklahoma
NPI 1750013652

Corwin John Ataddlety is a Peer Specialist based in Anadarko, OK. Corwin John Ataddlety practices in Anadarko, OK. The NPI Number for Corwin John Ataddlety is 1750013652 and holds a License No. (Oklahoma).

The current practice location address for Corwin John Ataddlety is 423 N 1St St, Anadarko, OK and can be reached out via phone at 405-247-2428.

Location: 423 N 1St St, Anadarko, OK, 73005-3705
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1750013652
Provider Name
Corwin John Ataddlety
Credential
Provider Entity Type
Individual
Gender
Male
Address
423 N 1St St, Anadarko, OK, 73005-3705
Phone Number
405-247-2428
Fax Number
Provider Enumeration Date
06/29/2022
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
034621147 01 OK SOONERCARE
institution
Provider Business Practice Location Address Details
Address
423 N 1St St
City
Anadarko
State
Oklahoma
Zip
73005-2111
Phone Number
405-247-2428
Fax Number
person
Provider Business Mailing Address Details
Address
423 N 1St St
City
Anadarko
State
Oklahoma
Zip
73005-2111
Phone Number
405-247-2428
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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