Provider Demographics
NPI:1982934998
Name:SAM, BESSIE MAE (MS LPC CANDIATE)
Entity Type:Individual
Prefix:MS
First Name:BESSIE
Middle Name:MAE
Last Name:SAM
Suffix:
Gender:F
Credentials:MS LPC CANDIATE
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Mailing Address - Street 1:721 S GEORGE NIGH EXPY # 4
Mailing Address - Street 2:#4
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-7400
Mailing Address - Country:US
Mailing Address - Phone:918-302-0909
Mailing Address - Fax:918-302-0405
Practice Address - Street 1:721 S GEORGE NIGH EXPY # 4
Practice Address - Street 2:#4
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-7400
Practice Address - Country:US
Practice Address - Phone:918-302-0909
Practice Address - Fax:918-302-0405
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health