Individual
MS. MAVIS WYANEMA RISENHOOVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1407 NE D ST, SUITE B, STIGLER, OK 74462-2815
(918) 967-8491
(918) 967-2552
Mailing address
1101 E MONROE AVE, MCALESTER, OK 74501-4815
(918) 426-7800
(918) 426-5526
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3198
OK
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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