Provider Demographics
NPI:1275787897
Name:SIEGEL, GEINA MARIE (BS)
Entity Type:Individual
Prefix:MRS
First Name:GEINA
Middle Name:MARIE
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:MS
Other - First Name:GEINA
Other - Middle Name:MARIE
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:PO BOX 1404
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74502-1404
Mailing Address - Country:US
Mailing Address - Phone:918-423-6030
Mailing Address - Fax:918-423-2370
Practice Address - Street 1:628 E CREEK AVE
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-6930
Practice Address - Country:US
Practice Address - Phone:918-423-6030
Practice Address - Fax:918-423-2370
Is Sole Proprietor?:No
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)