Healthcare Provider Details

I. General information

NPI: 1063746832
Provider Name (Legal Business Name): SHARON HILBURN DEMIER M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2009
Last Update Date: 09/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6670 S LEWIS AVE STE 200
TULSA OK
74136-1035
US

IV. Provider business mailing address

8928 E 62ND CIR
TULSA OK
74133-6357
US

V. Phone/Fax

Practice location:
  • Phone: 918-949-1148
  • Fax:
Mailing address:
  • Phone: 918-994-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: