Mixon, Susan Thomas

Mixon, Susan Thomas is an sole proprietor health care provider with primary practice located at 108 Rosewood Dr , Poteau OK 74953-2232. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Mixon, Susan Thomas can be contacted via phone (918) 658-5438.

Contact Information

Primary practice address
108 Rosewood Dr Poteau OK 74953-2232
Phone: (918) 658-5438
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X Oklahoma
Behavioral Health & Social Service Providers / School 103TS0200X Oklahoma

Profile Details

NPI number 1558647008
LBN Legal business name Mixon, Susan Thomas
Credentials M.S., J.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 28th, 2011
Last updated Oct 28th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558647008 NPPES
Oklahoma MEDICAID 200226970

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