NPI 1518373513

Dana Boldt Green, M.Ed., Lpc, Ncgc-2, PC

Organisation Community/Behavioral Health Agency Kingston, OK

Practice location

Address: 8800 Birch St, Kingston, OK 73439
Phone: (580) 565-2252
Mailing address: PO Box 1800, Kingston, OK 73439-1800

Authorised official

Name: Dana Green
Title: President
Phone: 58505652252

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 2011 (OK)

Other Community/Behavioral Health providers in Oklahoma →

Registry record

NPI: 1518373513
Entity type: Organization
NPI issued: 10 Jul 2014
Record last updated: 10 Jul 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.