Individual provider · Type 1 NPI

Tyler Wade Goodman

Peer Specialist · Ponca City, OK

NPI number 1124884242 Active

Practice location

93 Noel Ln
Ponca City, OK 74604-5443

Call (580) 485-5796 Map

Mailing address

Grand Mental Health 407 S Ave
Ponca City, OK 74604-5443

Other practice locations

  • 93 Noel Ln, Ponca City, OK 74604-5443 · (580) 485-5796

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 1124884242

Tyler Wade Goodman's National Provider Identifier is 1124884242, issued on Feb 26, 2024. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Ponca City, OK. The record was last updated on Mar 20, 2024.