Individual
JUDY SHRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24919 S 4420 RD, VINITA, OK 74301
(918) 256-9210
Mailing address
PO BOX 98, VINITA, OK 74301-0098
(918) 323-2137
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/10/2021
Last updated
04/10/2021
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