Individual provider · Type 1 NPI
Raven Jacinda Wall, CADC UNDER SUPERVISI
Addiction (Substance Use Disorder) Counselor · Norman, OK
NPI number
1457524027
Active
Practice location
2920 Chautauqua Ave Apt 38
Norman, OK 73072-7736
Fax (405) 528-8692
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1457524027
Raven Jacinda Wall, CADC UNDER SUPERVISI's National Provider Identifier is 1457524027, issued on Apr 3, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Norman, OK. The record was last updated on Apr 3, 2008.