Provider Demographics
NPI:1730471889
Name:COCHRAN, DAYNA MARIE
Entity Type:Individual
Prefix:
First Name:DAYNA
Middle Name:MARIE
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 NE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SPIRO
Mailing Address - State:OK
Mailing Address - Zip Code:74959-3003
Mailing Address - Country:US
Mailing Address - Phone:479-221-6334
Mailing Address - Fax:
Practice Address - Street 1:611 NE 2ND ST
Practice Address - Street 2:
Practice Address - City:SPIRO
Practice Address - State:OK
Practice Address - Zip Code:74959-3003
Practice Address - Country:US
Practice Address - Phone:479-221-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-09
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health