Individual provider · Type 1 NPI

Ethan Wayne Hancock

Peer Specialist · Moore, OK

NPI number 1861334294 Active

Practice location

2617 Ethan Ln
Moore, OK 73160-2390

Call (918) 549-8739 Map

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 1861334294

Ethan Wayne Hancock's National Provider Identifier is 1861334294, issued on Apr 6, 2026. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Moore, OK. The record was last updated on Apr 6, 2026.