Healthcare Provider Details

I. General information

NPI: 1548625742
Provider Name (Legal Business Name): DARCY J. HUISMANN GENETIC COUNSELOR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2015
Last Update Date: 11/29/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 CHILDRENS AVE
OKLAHOMA CITY OK
73104-4637
US

IV. Provider business mailing address

1200 CHILDRENS AVE STE 12100
OKLAHOMA CITY OK
73104-4637
US

V. Phone/Fax

Practice location:
  • Phone: 405-271-8685
  • Fax:
Mailing address:
  • Phone: 405-271-8001
  • Fax: 405-247-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number0246
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: