Individual provider · Type 1 NPI

Bryon Keith Wade Jr.

Peer Specialist · Pryor, OK

NPI number 1104794973 Active

Practice location

109 N Fairland St
Pryor, OK 74361-4205

Call (918) 625-6128 Map

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: 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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About NPI 1104794973

Bryon Keith Wade Jr.'s National Provider Identifier is 1104794973, issued on Oct 24, 2025. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Pryor, OK. The record was last updated on Oct 24, 2025.