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NPI Code Detail

MEDICARE: MICKELLA DRENNEN

MEDICARE: MICKELLA DRENNEN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1609387646
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICKELLA DRENNEN
Provider Business Mailing Address
First Line : PO BOX 662
Second Line :
City : PURCELL
State : OK
Zip : 73080-0662
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 314 S BROADWAY AVE STE 106
Second Line :
City : ADA
State : OK
Zip : 74820-5818
Country : US
Telephone Number : 580-235-0210
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2017
Last Update Date : 03/08/2026

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Directions to “ MICKELLA DRENNEN ” Practice Location

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