Individual
CAROL GROVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
.113653 HWY 69, CHECOTAH, OK 74426
(918) 689-7416
(918) 689-7431
Mailing address
PO BOX 48, MEAD, OK 73449-0048
(580) 745-9610
(580) 745-9891
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100708380
—
OK
05
—
200049040
—
OK
Enumeration date
11/07/2013
Last updated
11/07/2013
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