Organization
SHAWNEE MEDICAL CENTER CLINIC, INC
Active
Other names
SSM Health Shawnee Behavorial Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL L PENA (INSURANCE CREDENTIALING SPECIALIST)
(405) 272-7452
Entity
Organization
Contact information
Practice address
3315 KETHLEY RD, SHAWNEE, OK 74804-9638
(405) 273-5801
(405) 878-3794
Mailing address
3315 KETHLEY RD, SHAWNEE, OK 74804-9638
(405) 273-5801
(405) 878-3794
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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