Healthcare Provider Details

I. General information

NPI: 1225395866
Provider Name (Legal Business Name): MS. ASHLEY M DIAMOND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2012
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6226 E 101ST ST STE 150
TULSA OK
74137-7124
US

IV. Provider business mailing address

6226 E 101ST ST STE 150
TULSA OK
74137-7124
US

V. Phone/Fax

Practice location:
  • Phone: 918-400-9144
  • Fax:
Mailing address:
  • Phone: 918-400-9144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number5296
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberP082573608
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: