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NPI Code Detail

MEDICARE: LINDA MAXEY BS BHRS

MEDICARE: LINDA MAXEY BS BHRS
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 : 1790897783
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDA MAXEY BS BHRS
Provider Business Mailing Address
First Line : 105 SE 45TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73129-3201
Country : US
Telephone Number : 405-632-1900
Fax Number :
Provider Business Practice Location Address
First Line : 105 SE 45TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73129-3201
Country : US
Telephone Number : 405-632-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 12/29/2010

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