Individual
MISS ANGELA J SUMTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC
Contact information
Practice address
17675 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-5492
(918) 316-8258
Mailing address
PO BOX 948, TAHLEQUAH, OK 74465-0948
(918) 316-8258
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
364
OK
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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