Provider Demographics
NPI:1700059821
Name:CLICK, ROY
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:
Last Name:CLICK
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 1:311 B STREET NE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:OK
Mailing Address - Zip Code:74354
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:138 SOUTH MAIN
Practice Address - Street 2:
Practice Address - City:AFTON
Practice Address - State:OK
Practice Address - Zip Code:74331
Practice Address - Country:US
Practice Address - Phone:918-257-4244
Practice Address - Fax:918-257-4247
Is Sole Proprietor?:No
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health