Provider Demographics
NPI:1710136015
Name:SPRADLING, LYNETTE YVONNE
Entity Type:Individual
Prefix:MRS
First Name:LYNETTE
Middle Name:YVONNE
Last Name:SPRADLING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:931 8TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-4013
Mailing Address - Country:US
Mailing Address - Phone:580-238-8195
Mailing Address - Fax:
Practice Address - Street 1:2530 S COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73402
Practice Address - Country:US
Practice Address - Phone:580-226-5048
Practice Address - Fax:580-226-3569
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)