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 |