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1619094851
NATHANIEL DASH
MANGUM, OK
NPI
1619094851
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 145)
Enumeration Date
2007-03-23
Last Update Date
2007-07-08
Business Address
-- NATHANIEL DASH CADC
2 WICKERSHAM ST
MANGUM, OK 73554-9117
Phone number: 580-782-3337
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Mailing Address
-- NATHANIEL DASH CADC
710 E SUTHERLAND ST
ALTUS, OK 73521-4041
Phone number: 580-477-2871
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