Dewitt, Deidra

Dewitt, Deidra is an individual health care provider with primary practice located at 107 S High St , Antlers OK 74523-3818. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Dewitt, Deidra can be contacted via phone (580) 298-2830.

Contact Information

Primary practice address
107 S High St Antlers OK 74523-3818
Phone: (580) 298-2830
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1124560610
LBN Legal business name Dewitt, Deidra
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2016
Last updated Nov 15th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1124560610 NPPES
Oklahoma MEDICAID 100744370

Popular Providers