Beavers, Mirissa Joy

Beavers, Mirissa Joy is an individual health care provider with primary practice located at 193461 E. County Rd. 304 , Fort Supply OK 73841. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Beavers, Mirissa Joy can be contacted via phone (580) 766-2311.

Contact Information

Primary practice address
193461 E. County Rd. 304 Fort Supply OK 73841
Phone: (580) 766-2311
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1013553163
LBN Legal business name Beavers, Mirissa Joy
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 25th, 2019
Last updated Nov 25th, 2019 - about 6 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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