Individual provider · Type 1 NPI
Kourtland Blair McMillan
Peer Specialist · Wagner, OK
NPI number
1255196697
Active
Practice location
215 NE 1st Street
Wagner, OK 74467-6928
Mailing address
215 NE 1st St
Wagoner, OK 74467-4439
Other practice locations
- 215 NE 1st St, Wagoner, OK 74467-4439 · (918) 201-4333
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Peer Specialist Primary | 175T00000X | None 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.
About NPI 1255196697
Kourtland Blair McMillan's National Provider Identifier is 1255196697, issued on Feb 15, 2024. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Wagner, OK. The record was last updated on Feb 15, 2024.