Provider Demographics
NPI:1679865323
Name:CUMMINS, STEPHANIE JO (MED)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JO
Last Name:CUMMINS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 CLASSEN BLVD
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4616
Mailing Address - Country:US
Mailing Address - Phone:405-826-2802
Mailing Address - Fax:
Practice Address - Street 1:1151 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5331
Practice Address - Country:US
Practice Address - Phone:405-864-1420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor