Healthcare Provider Details
I. General information
NPI: 1962847681
Provider Name (Legal Business Name): S-CAP FOR WOMEN
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2013
Last Update Date: 05/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
128 S PETERS AVE
NORMAN OK
73069-6034
US
IV. Provider business mailing address
128 S PETERS AVE
NORMAN OK
73069-6034
US
V. Phone/Fax
- Phone: 405-701-8163
- Fax: 405-310-3739
- Phone: 405-701-8163
- Fax: 405-310-3739
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROCK
RICHARDSON
Title or Position: DIRECTOR
Credential:
Phone: 405-701-8138