MEDICARE: MRS. GEORGIA SIGLE

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	390200000X	Student in an Organized Health Care Education/Training Program
2	101YP2500X	Professional Counselor	5235	OK
3	101YM0800X	Mental Health Counselor	5235	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326299827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GEORGIA SIGLE

Provider Business Mailing Address
First Line	:	1112 LAUREL CREEK DR
Second Line	:
City	:	YUKON
State	:	OK
Zip	:	73099-5832
Country	:	US
Telephone Number	:	405-693-9886
Fax Number	:

Provider Business Practice Location Address
First Line	:	530 POINTE PARKWAY BLVD
Second Line	:	SUITE B
City	:	YUKON
State	:	OK
Zip	:	73099-0600
Country	:	US
Telephone Number	:	405-693-9886
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2008
Last Update Date	:	02/20/2014

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