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NPI Code Detail

MEDICARE: LASHA KAY CLABORN

MEDICARE: LASHA KAY CLABORN
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 : 1790978658
Entity Type Code : Individual
Provider Name (Legal Business Name) : LASHA KAY CLABORN
Provider Business Mailing Address
First Line : 6620 NW 25TH ST
Second Line :
City : BETHANY
State : OK
Zip : 73008-4712
Country : US
Telephone Number : 405-609-9807
Fax Number :
Provider Business Practice Location Address
First Line : 301 W I 240 SERVICE RD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73139-7701
Country : US
Telephone Number : 405-635-3851
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2007
Last Update Date : 09/16/2014

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Directions to “ LASHA KAY CLABORN ” Practice Location

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