MEDICARE: VARNER CONSULTATION LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1235581497
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VARNER CONSULTATION LLC

Provider Business Mailing Address
First Line	:	5009 N PENNSYLVANIA AVE
Second Line	:	SUITE 114
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-8887
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5009 N PENNSYLVANIA AVE
Second Line	:	SUITE 114
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-8887
Country	:	US
Telephone Number	:	405-924-2171
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	POLINA VARNER
Credential	:	LCSW
Telephone Number	:	405-924-2171

Provider Enumeration Date	:	07/12/2016
Last Update Date	:	07/12/2016

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