MEDICARE: MRS. CARRIE GUY MS, CGC, LGC

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1710962493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CARRIE GUY MS, CGC, LGC

Provider Business Mailing Address
First Line	:	1200 CHILDRENS AVE
Second Line	:	SUITE 12100
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-4637
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 CHILDRENS AVE
Second Line	:	SUITE 12100
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-4637
Country	:	US
Telephone Number	:	405-271-8685
Fax Number	:

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	10/09/2012

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