Healthcare Provider Details

I. General information

NPI: 1962648329
Provider Name (Legal Business Name): SUSAN D BARLOW M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2009
Last Update Date: 01/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 CRADDUCK RD
ADA OK
74820-9491
US

IV. Provider business mailing address

120 ACKER DR
ADA OK
74820-7201
US

V. Phone/Fax

Practice location:
  • Phone: 405-310-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: