Provider Demographics
NPI:1467693762
Name:CLOWER, MISTY DAWN (MS MH COUNSLING)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:DAWN
Last Name:CLOWER
Suffix:
Gender:F
Credentials:MS MH COUNSLING
Other - Prefix:MRS
Other - First Name:MISTY
Other - Middle Name:DAWN
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BS
Mailing Address - Street 1:1101 E MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4815
Mailing Address - Country:US
Mailing Address - Phone:918-426-7800
Mailing Address - Fax:
Practice Address - Street 1:117 ROGERS DRIVE
Practice Address - Street 2:
Practice Address - City:HOLDENVILLE
Practice Address - State:OK
Practice Address - Zip Code:74848-2877
Practice Address - Country:US
Practice Address - Phone:405-379-6668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-16
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)