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General NPI Number Information
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NPI Number | 1346504115
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Entity Type | Individual
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Provider Name | DANIEL WEST
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Gender | Male
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 564 SPARROW RD
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City | VALLIANT
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State | OK
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Zip | 74764-9793
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Country | US
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Telephone | 580-933-5286
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Fax |
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Provider Business Mailing Address
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Address Line | 564 SPARROW RD
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City | VALLIANT
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State | OK
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Zip | 74764-5472
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Country | US
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Telephone | 580-933-5286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State | OK
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