Healthcare Provider Details

I. General information

NPI: 1598125593
Provider Name (Legal Business Name): SEBIEN TREAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2016
Last Update Date: 09/19/2024
Certification Date: 09/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 W 13TH ST
ATOKA OK
74525-3712
US

IV. Provider business mailing address

908 S RACE ST
COALGATE OK
74538-3029
US

V. Phone/Fax

Practice location:
  • Phone: 580-889-5555
  • Fax: 580-889-1925
Mailing address:
  • Phone: 580-927-8421
  • Fax: 580-745-9891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: