MEDICARE: MS. DIANA WINSLOW MSW

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	20996	OK

General Provider Information

NPI Number	:	1629033063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANA WINSLOW MSW

Provider Business Mailing Address
First Line	:	14901 NORTH PENNSYLVANIA AVENUE
Second Line	:	SUITE #222-B
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-6074
Country	:	US
Telephone Number	:	405-203-6976
Fax Number	:

Provider Business Practice Location Address
First Line	:	1607 N.E. 23RD STREET
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73111-3243
Country	:	US
Telephone Number	:	405-203-6976
Fax Number	:	405-535-5835

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	08/12/2024

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