Samantha Johnette Sowers, | |
404 S Monroe Ave, Wagoner, OK 74467-6200 | |
(918) 680-0420 | |
Not Available |
Full Name | Samantha Johnette Sowers |
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Gender | Female |
Speciality | Counselor - Mental Health |
Location | 404 S Monroe Ave, Wagoner, Oklahoma |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1588276133 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
Entity Name | Grand Lake Mental Health Center, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1497762520 PECOS PAC ID: 4688711534 Enrollment ID: O20091026000174 |
Mailing Address | Practice Location Address |
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Samantha Johnette Sowers, 404 S Monroe Ave, Wagoner, OK 74467-6200 Ph: () - | Samantha Johnette Sowers, 404 S Monroe Ave, Wagoner, OK 74467-6200 Ph: (918) 680-0420 |
James C Washington, Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Se 11th St, Wagoner, OK 74467 Phone: 918-485-5404 Fax: 918-485-8541 | |
Carleen Noe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Se 11th St, Wagoner, OK 74467 Phone: 918-485-8404 Fax: 918-485-8541 | |
Kamilah Scroggins, Counselor Medicare: Not Enrolled in Medicare Practice Location: 68512 S 310 Rd, Wagoner, OK 74467 Phone: 661-972-8815 | |
Debra Williams, Counselor Medicare: Not Enrolled in Medicare Practice Location: 301 Se 11th St, Wagoner, OK 74467 Phone: 918-485-8404 Fax: 918-485-8541 | |
Tracy Lea Martin, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 S Harrill, Eri, Wagoner, OK 74467 Phone: 918-485-3554 Fax: 918-485-8371 | |
Angelina C Hayes, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2109 S Highway 69, Wagoner, OK 74467 Phone: 918-485-0242 Fax: 918-485-0204 | |
Madison M Medlock, Counselor Medicare: Not Enrolled in Medicare Practice Location: 109 S Harrill Ave, Wagoner, OK 74467 Phone: 918-485-0242 Fax: 918-485-0242 |