Healthcare Provider Details

I. General information

NPI: 1477924181
Provider Name (Legal Business Name): SAMANTHA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SE GRAND BLVD
OKLAHOMA CITY OK
73129-4948
US

IV. Provider business mailing address

500 SE GRAND BLVD
OKLAHOMA CITY OK
73129-4948
US

V. Phone/Fax

Practice location:
  • Phone: 405-605-8232
  • Fax: 405-702-9433
Mailing address:
  • Phone: 405-605-8232
  • Fax: 405-702-9433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: