Individual
SUSAN LEIGH MUSTAFINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED
Contact information
Practice address
905 E WILSON ST, SHAWNEE, OK 74804-4165
(405) 214-0116
Mailing address
33007 45TH ST, SHAWNEE, OK 74804-3429
(405) 395-7548
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200362320B
—
OK
Enumeration date
08/02/2011
Last updated
03/01/2024
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