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General NPI Number Information
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NPI Number | 1194082693
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Entity Type | Organization
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Legal Business Name | GLORIA D WORTHY-MUHAMMAD
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Dates
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Enumeration Date | 04/20/2012
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Last Update Date | 04/20/2012
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Provider Practice Location Address
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Address Line | 13 OAKWOOD DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73121-5410
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Country | US
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Telephone | 405-250-5960
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Fax |
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Provider Business Mailing Address
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Address Line | 13 OAKWOOD DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73121-5410
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Country | US
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Telephone | 405-250-5960
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | GLORIA WORTHY-MUHAMMAD
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Credential | M.A.
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Telephone | 405-250-5960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 3935
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License Number State | OK
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