Individual
MRS. MODINA PELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 W. HARBER RD, GROVE, OK 74344-3505
(918) 786-4434
Mailing address
1115 W. HARBER RD, GROVE, OK 74344-3505
(918) 786-4434
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/01/2013
Last updated
12/03/2013
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