Individual
JEMMIE RENAH MAUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
501 N TAYLOR ST TRLR 6, PRYOR, OK 74361-2025
(918) 244-5711
Mailing address
501 N TAYLOR ST TRLR 6, PRYOR, OK 74361-2025
(918) 244-5711
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
12/05/2025
Last updated
12/05/2025
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