Organization
GEM EXPANSIVE SERVICES, LLC
Active
Other names
GEM-X
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY K WELCH LCSW (OWNER)
(539) 900-3065
Entity
Organization
Contact information
Practice address
9708 N 98TH EAST AVE, OWASSO, OK 74055-6749
(539) 900-3065
Mailing address
8086 S YALE AVE # 272, TULSA, OK 74136-9003
(539) 900-3065
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588819882
—
OK
Enumeration date
02/18/2021
Last updated
02/18/2021
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