Della Logsdon, PRSS
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Mangum, OK
NPI 1992033872 · NPPES record last updated Dec 3, 2009
Key facts
- NPI
- 1992033872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 904207 (OK)
- Practice address
- 2 Wickersham St
Mangum, OK 73554-9117 - Phone
- (580) 782-3337
- NPI assigned
- Dec 3, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 904207 | OK | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 904207 | OK | Yes |
Addresses
Primary practice location
2 Wickersham St
Mangum, OK 73554-9117
Mailing address
PO Box 376
Granite, OK 73547-0376
Phone (580) 301-4060
Other providers in Mangum, OK
- Maria Lara
- Shelly J Larson
- Angela Little
- Dustin Curt Lively
- Benjamin Moses Locklear
- James Andrew Macrobert
- Mangum City Hospital Authority
- Mangum City Hospital Authority
- Mangum City Hospital Authority
- Mangum City Hospital Authority
All providers in Mangum, OK · Addiction (Substance Use Disorder) Counselor in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.