| Gem Expansive Services, Llc | |
|
9708 N 98th East Ave Owasso OK 74055-6749 | |
| (539) 900-3065 | |
| Not Available |
| Full Name | Gem Expansive Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 9708 N 98th East Ave, Owasso, Oklahoma |
| Authorized Official Name and Position | Kimberly K Welch (OWNER) |
| Authorized Official Contact | 5399003065 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gem Expansive Services, Llc 8086 S Yale Ave # 272 Tulsa OK 74136-9003 Ph: (539) 900-3065 | Gem Expansive Services, Llc 9708 N 98th East Ave Owasso OK 74055-6749 Ph: (539) 900-3065 |
| NPI Number | 1639762719 |
|---|---|
| Provider Enumeration Date | 02/18/2021 |
| Last Update Date | 02/18/2021 |
| Certification Date | 02/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639762719 | NPI | - | NPPES |
| 1588819882 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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