Healthcare Provider Details

I. General information

NPI: 1043756893
Provider Name (Legal Business Name): AURI ALBERT BS, CMII
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2017
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 N 31ST ST
CLINTON OK
73601
US

IV. Provider business mailing address

10348 HIGHWAY 54
WEATHERFORD OK
73096-4662
US

V. Phone/Fax

Practice location:
  • Phone: 580-323-9733
  • Fax:
Mailing address:
  • Phone: 580-302-0538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: