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Individual

BEVERLY SUMMITT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
RR 1 BOX 1619, CEMENT, OK 73017-9735
(405) 209-2833
Mailing address
RR 1 BOX 1619, CEMENT, OK 73017-9735
(405) 209-2833

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
08/09/2012
Last updated
08/09/2012
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