| Grundy Psychological Services, P.c. | |
|
205 Ketchum Avenue Ketchum OK 74349 | |
| (918) 629-8664 | |
| (918) 782-4301 |
| Full Name | Grundy Psychological Services, P.c. |
|---|---|
| Speciality | Psychologist - Health Service |
| Location | 205 Ketchum Avenue, Ketchum, Oklahoma |
| Authorized Official Name and Position | Elizabeth Mollette Grundy (VICE PRESIDENT) |
| Authorized Official Contact | 9188558315 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grundy Psychological Services, P.c. Po Box 6 Ketchum OK 74349-0006 Ph: (918) 629-8664 | Grundy Psychological Services, P.c. 205 Ketchum Avenue Ketchum OK 74349 Ph: (918) 629-8664 |
| NPI Number | 1457827016 |
|---|---|
| Provider Enumeration Date | 10/22/2018 |
| Last Update Date | 10/22/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457827016 | NPI | - | NPPES |
| 100839060A | Medicaid | OK | |
| 100838100A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | (* (Not Available)) | Primary |