Organization
INDIVIDUAL & FAMILY SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLEATTA SHUMATE-JOHNSON M.ED. (LICENSED PROFESSIONAL COUNSELOR)
(918) 794-2847
Entity
Organization
Contact information
Practice address
2840 E 51ST ST, 105, TULSA, OK 74105-1744
(918) 794-2847
(918) 747-6601
Mailing address
2840 E 51ST ST, 105, TULSA, OK 74105-1744
(918) 794-2847
(918) 747-6601
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2503
OK
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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