Individual provider · Type 1 NPI

Lanica Willaby

Peer Specialist · Wagoner, OK

NPI number 1578101002 Active

Practice location

307 E Cherokee St
Wagoner, OK 74467-4729

Call (918) 485-7991 Map

Mailing address

307 E Cherokee St Rm 215
Wagoner, OK 74467-4729

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 1578101002

Lanica Willaby's National Provider Identifier is 1578101002, issued on Dec 16, 2019. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Wagoner, OK. The record was last updated on Dec 16, 2019.