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NPI 1114442092

NPI 1114442092 : CAROLYN J RAINWATER : LONE GROVE, OK

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General NPI Number Information
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    NPI Number           |    1114442092
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    Entity Type          |    Individual 
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    Provider Name        |    CAROLYN J RAINWATER
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/11/2017
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    Last Update Date     |    07/08/2025
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Provider Practice Location Address
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    Address Line         |    83 ORCHARD ST 
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    City                 |    LONE GROVE
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    State                |    OK
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    Zip                  |    73443-6443
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    Country              |    US
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    Telephone            |    580-630-4229
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1732 
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    City                 |    LONE GROVE
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    State                |    OK
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    Zip                  |    73443-1732
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    Country              |    US
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    Telephone            |    580-630-4229
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    Fax                  |    580-630-4229
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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