Healthcare Provider Details

I. General information

NPI: 1306282694
Provider Name (Legal Business Name): LIEN N MIU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 05/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 NE 63RD ST
OKLAHOMA CITY OK
73105-6411
US

IV. Provider business mailing address

408 NW 137TH ST
EDMOND OK
73013-2402
US

V. Phone/Fax

Practice location:
  • Phone: 405-753-7159
  • Fax:
Mailing address:
  • Phone: 405-512-1023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: