SAMANTHA RONAE BUMGUARDNER, YOUTH SERVICE

NPI: 1013738244 · Individual · Active

Primary Specialty

Counselor

Practice Location

205 J T STITES BLVD
SALLISAW, OK 74955-9323 Map ↗
Phone: 918-775-7787
Fax: 918-775-0328

Mailing Address

205 S J T STITES ST
SALLISAW, OK 74955-9301 Map ↗
Phone: 918-775-7787

Used for billing & correspondence; clinical visits at the Practice Location above.

All Specialties & Licenses

  • Counselor Primary

NPI Registration

Enumerated: 2024-10-21

Last CMS Update: 2024-10-21