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General NPI Number Information
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NPI Number | 1578702577
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Entity Type | Organization
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Legal Business Name | JENNIFER CREMIN SELLERS, PLLC
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Dates
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Enumeration Date | 02/13/2009
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 6853 S CANTON AVE
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City | TULSA
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State | OK
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Zip | 74136-3405
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Country | US
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Telephone | 918-496-8050
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Fax | 918-496-9597
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Provider Business Mailing Address
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Address Line | 11421 S JOPLIN AVE
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City | TULSA
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State | OK
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Zip | 74137-7753
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Country | US
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Telephone | 918-298-3831
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MRS. JENNIFER CREMIN SELLERS
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Credential | LCSW
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Telephone | 918-724-3831
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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 | 2832
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License Number State | OK
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