Healthcare Provider Details

I. General information

NPI: 1144391707
Provider Name (Legal Business Name): SHERYL ANN ZUMWALT L.P.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 S BOSTON AVE SUITE 400
TULSA OK
74119-1208
US

IV. Provider business mailing address

4615 E 93RD CT UNIT B
TULSA OK
74137-3968
US

V. Phone/Fax

Practice location:
  • Phone: 918-382-7300
  • Fax: 918-382-7302
Mailing address:
  • Phone: 918-382-7300
  • Fax: 918-382-7302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2573
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: