Individual
MRS. GLENANNETTA MAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-C, BSN, RN
Contact information
Practice address
1402 MAXEY DR, MUSKOGEE, OK 74403-1101
(918) 616-6968
Mailing address
1402 MAXEY DR, MUSKOGEE, OK 74403-1101
(918) 616-6968
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
163WC0400X
Case Management Registered Nurse
0089870
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201128730B
—
OK
Enumeration date
09/19/2021
Last updated
04/19/2024
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