Provider Demographics
NPI:1134978521
Name:HALE, CADEN SAMUEL
Entity type:Individual
Prefix:
First Name:CADEN
Middle Name:SAMUEL
Last Name:HALE
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 1:204 W 168TH ST S
Mailing Address - Street 2:
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-5267
Mailing Address - Country:US
Mailing Address - Phone:918-277-7630
Mailing Address - Fax:
Practice Address - Street 1:204 W 168TH ST S
Practice Address - Street 2:
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-5267
Practice Address - Country:US
Practice Address - Phone:918-277-7630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator