Healthcare Provider Details

I. General information

NPI: 1710028592
Provider Name (Legal Business Name): SYLVIA M SUAREZ LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 N. FLOOD AVENUE
NORMAN OK
73069
US

IV. Provider business mailing address

1116 FOUNTAIN GATE CT
NORMAN OK
73072-3908
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-3719
  • Fax: 405-364-3209
Mailing address:
  • Phone: 405-292-2078
  • Fax: 405-364-3209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3113
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: