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General NPI Number Information
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NPI Number | 1467693762
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Entity Type | Individual
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Provider Name | MISTY DAWN CLOWER M.S. MH COUNSLING
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Gender | Female
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Dates
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Enumeration Date | 03/16/2009
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 117 ROGERS DRIVE
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City | HOLDENVILLE
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State | OK
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Zip | 74848-2877
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Country | US
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Telephone | 405-379-6668
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Fax |
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Provider Business Mailing Address
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Address Line | 1101 E MONROE AVE
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City | MCALESTER
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State | OK
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Zip | 74501-4815
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Country | US
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Telephone | 918-426-7800
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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