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1124315130
ANGELA J SUMTER
TAHLEQUAH, OK
NPI
1124315130
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OK 364)
Enumeration Date
2011-06-29
Last Update Date
2011-06-29
Business Address
Miss ANGELA J SUMTER CADC
17675 S MUSKOGEE AVE
TAHLEQUAH, OK 74464-5492
Phone number: 918-316-8258
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Mailing Address
Miss ANGELA J SUMTER CADC
PO BOX 948
TAHLEQUAH, OK 74465-0948
Phone number: 918-316-8258
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