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General NPI Number Information
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NPI Number | 1275634958
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Entity Type | Individual
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Provider Name | BEVERAL DARLENE MCCLURE L.C.S.W
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 921 NE 13TH ST # 183H
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City | OKLAHOMA CITY
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State | OK
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Zip | 73104-5007
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Country | US
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Telephone | 405-270-0501
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Fax | 405-290-1777
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Provider Business Mailing Address
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Address Line | 14374 FONTELLA LN
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City | EDMOND
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State | OK
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Zip | 73034-9320
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Country | US
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Telephone | 405-359-7208
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 1520
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License Number State | OK
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