Healthcare Provider Details

I. General information

NPI: 1871425280
Provider Name (Legal Business Name): SARAH BEAVER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4219 VICKSBURG
ENID OK
73703-2000
US

IV. Provider business mailing address

4219 VICKSBURG
ENID OK
73703-2000
US

V. Phone/Fax

Practice location:
  • Phone: 580-242-4673
  • Fax:
Mailing address:
  • Phone: 580-242-4673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number458300
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: