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General NPI Number Information
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NPI Number | 1760156699
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Entity Type | Organization
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Legal Business Name | SHARON GROVES, PLLC
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 5613 N OAKWOOD RD
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City | ENID
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State | OK
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Zip | 73703-9345
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Country | US
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Telephone | 580-747-9487
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3504
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City | ENID
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State | OK
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Zip | 73702-3504
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Country | US
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Telephone | 580-747-9487
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | SHARON GROVES
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Credential | LCSW
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Telephone | 580-747-9487
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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