Individual provider · Type 1 NPI
Edward Clyde Skidmore Jr., R.S.S.
Addiction (Substance Use Disorder) Counselor · Ardmore, OK
NPI number
1992081137
Active
Practice location
417 Cottonwood St
Ardmore, OK 73401-1732
Mailing address
PO Box 1327
Ardmore, OK 73402-1327
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
| Mental Health Counselor | 101YM0800X | None listed |
| Pastoral Counselor | 101YP1600X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1992081137
Edward Clyde Skidmore Jr., R.S.S.'s National Provider Identifier is 1992081137, issued on Nov 2, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Ardmore, OK. The record was last updated on Nov 2, 2011.