Healthcare Provider Details

I. General information

NPI: 1912194747
Provider Name (Legal Business Name): AMBER DAWN BARBEAU MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5525 E 51ST ST SUITE #400
TULSA OK
74135-7461
US

IV. Provider business mailing address

8506 S 70TH EAST AVE
TULSA OK
74133-5085
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-0859
  • Fax: 918-388-6456
Mailing address:
  • Phone: 918-488-9428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: