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1124247697
JANINE LINDA MANGRUM
MCALESTER, OK
NPI
1124247697
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 175)
Enumeration Date
2007-04-24
Last Update Date
2007-07-08
Business Address
-- JANINE LINDA MANGRUM M.S., L.A.D.C.
1210 N WEST ST
MCALESTER, OK 74501-2306
Phone number: 918-421-3323
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Mailing Address
-- JANINE LINDA MANGRUM M.S., L.A.D.C.
PO BOX 115
SAVANNA, OK 74565-0115
Phone number: 918-548-3326
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