Individual
AMY D HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1115 HARBER RD., GROVE, OK 74344
(918) 786-4434
(918) 786-4435
Mailing address
PO BOX 451385, GROVE, OK 74345-1385
(918) 786-4434
(918) 786-4435
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3737
OK
Other
Enumeration date
04/27/2007
Last updated
09/20/2011
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