Individual provider · Type 1 NPI

Cody Wayne Clark

Peer Specialist · Ponca City, OK

NPI number 1336968767 Active

Practice location

620 W Grand Ave
Ponca City, OK 74601-5123

Call (580) 762-1462 Map

Fax (581) 765-7299

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 1336968767

Cody Wayne Clark's National Provider Identifier is 1336968767, issued on Oct 3, 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 Oct 3, 2024.