Organization
JP SPAVINAW CREEK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARET AILEEN PLUMMER LCSW (MEMBER/PARTNER)
(918) 589-2160
Entity
Organization
Contact information
Practice address
401 CENTER AVE, SPAVINAW, OK 74366-0353
(918) 589-2160
Mailing address
PO BOX 353, 401 CENTER AVENUE, SPAVINAW, OK 74366-0353
(918) 589-2160
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2502
OK
1041C0700X
Clinical Social Worker
0053
OK
Other
Enumeration date
10/18/2012
Last updated
10/18/2012
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