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NPI Code Detail

MEDICARE: MS. AMBER LYNN ROAT BT

MEDICARE: MS. AMBER LYNN ROAT BT
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
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1578574265
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AMBER LYNN ROAT BT
Provider Business Mailing Address
First Line : 1211 MAGNOLIA CT
Second Line :
City : MOORE
State : OK
Zip : 73160-1397
Country : US
Telephone Number : 405-410-7644
Fax Number :
Provider Business Practice Location Address
First Line : 1211 MAGNOLIA CT
Second Line :
City : MOORE
State : OK
Zip : 73160-1397
Country : US
Telephone Number : 405-410-7644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 07/31/2024

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