Individual
MICHELLE L CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
114 N GRAND AVE STE 512, OKMULGEE, OK 74447-4013
(918) 759-1504
Mailing address
114 N GRAND AVE STE 512, OKMULGEE, OK 74447-4013
(918) 759-1504
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/02/2013
Last updated
03/17/2018
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