Provider Demographics
NPI:1285242735
Name:GONZALEZ SCHMENK, MARNA JANE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MARNA
Middle Name:JANE
Last Name:GONZALEZ SCHMENK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8403 E 110TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-7336
Mailing Address - Country:US
Mailing Address - Phone:951-295-6138
Mailing Address - Fax:
Practice Address - Street 1:631 N BROWN ST
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-3229
Practice Address - Country:US
Practice Address - Phone:918-224-1492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7326104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker