Provider Demographics
NPI:1689961286
Name:SOVO, GINA
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:SOVO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:OK
Mailing Address - Zip Code:73567-0211
Mailing Address - Country:US
Mailing Address - Phone:580-583-1490
Mailing Address - Fax:
Practice Address - Street 1:10342 GREENBRIAR PKWY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7643
Practice Address - Country:US
Practice Address - Phone:405-759-2516
Practice Address - Fax:405-759-2578
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-03
Last Update Date:2011-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor