Provider Demographics
NPI:1972862985
Name:WARE, QUANTON D (BS)
Entity Type:Individual
Prefix:MR
First Name:QUANTON
Middle Name:D
Last Name:WARE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8321 NE 33RD ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:OK
Mailing Address - Zip Code:73084-3103
Mailing Address - Country:US
Mailing Address - Phone:405-414-5394
Mailing Address - Fax:
Practice Address - Street 1:8321 NE 33RD ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:OK
Practice Address - Zip Code:73084-3103
Practice Address - Country:US
Practice Address - Phone:405-414-5394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor