Individual
JANICE KAYE SAMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
351 N AIR DEPOT BLVD, MIDWEST CITY, OK 73110-1700
(405) 610-6540
Mailing address
351 N AIR DEPOT BLVD, MIDWEST CITY, OK 73110-1700
(405) 610-6540
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447559711
—
OK
Enumeration date
10/19/2012
Last updated
10/19/2012
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