Individual
MARY E SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS/BHRS
Contact information
Practice address
4122 W 55TH PLACE S., SUITE 119, TULSA, OK 74107-9108
(918) 486-9996
(800) 260-7966
Mailing address
3705 W DETROIT ST, BROKEN ARROW, OK 74012-2183
(918) 361-4664
(800) 260-7966
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6100
OK
225C00000X
Rehabilitation Counselor
BHRS CERTIFICATION
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OK
Enumeration date
08/19/2013
Last updated
03/04/2021
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