Healthcare Provider Details

I. General information

NPI: 1316094675
Provider Name (Legal Business Name): PAMELA YVONNE HILLIARD BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W LINN ST
NORMAN OK
73069-5837
US

IV. Provider business mailing address

20006 MACARTHUR AVE
BLANCHARD OK
73010-4941
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-0022
  • Fax: 405-360-4918
Mailing address:
  • Phone: 405-344-6425
  • Fax:

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: