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NPI Code Detail

MEDICARE: MRS. ENSIE DRUMGO M.S.

MEDICARE: MRS. ENSIE DRUMGO M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1316266125
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ENSIE DRUMGO M.S.
Provider Business Mailing Address
First Line : PO BOX 181
Second Line :
City : ADA
State : OK
Zip : 74821-0181
Country : US
Telephone Number : 580-332-4370
Fax Number :
Provider Business Practice Location Address
First Line : 901 W 18TH ST
Second Line :
City : ADA
State : OK
Zip : 74820-7423
Country : US
Telephone Number : 580-436-6130
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2010
Last Update Date : 05/19/2010

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Directions to “ MRS. ENSIE DRUMGO M.S.” Practice Location

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