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Ebony Dawn-Compton Fields

Case Manager/Care Coordinator in Idabel, OK. Individual provider (NPI-1).

NPI number1215768429
StatusActive
Last updated in NPPESAug 9, 2024

Details

NPI
1215768429
Entity type
Individual (NPI-1)
Name
Ebony Dawn-Compton Fields
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 9, 2024
Certification date
Aug 9, 2024
Last updated
Aug 9, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171M00000X Case Manager/Care CoordinatorG081497136OKYes

Practice location

312 Se Ave K
Idabel, OK 74745-5008

Phone 580-212-2787

Mailing address

312 Se Ave K
Idabel, OK 74745-5008

Phone 580-212-2787

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