Organization · Type 2 NPI
JP Spavinaw Creek LLC
Professional Counselor · Spavinaw, OK
NPI number
1366795015
Active
Practice location
401 Center Ave
Spavinaw, OK 74366-0353
Mailing address
PO Box 353, 401 Center Avenue
Spavinaw, OK 74366-0353
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | 2502 (OK) |
| Clinical Social Worker | 1041C0700X | 0053 (OK) |
Professional Counselor: Definition to come...
About NPI 1366795015
JP Spavinaw Creek LLC's National Provider Identifier is 1366795015, issued on Oct 18, 2012. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Spavinaw, OK. The record was last updated on Oct 18, 2012.