| NPI | 1134688146 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP WOMEN'S BEHAVIORAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Provider Enrollment 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2019-03-19 |