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General NPI Number Information
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NPI Number | 1083411961
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Entity Type | Individual
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Provider Name | HEATHER ANTHONY
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Gender |
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 13301 N MERIDIAN AVE STE 100
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-8357
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Country | US
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Telephone | 405-310-3262
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 24TH AVE NW
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City | NORMAN
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State | OK
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Zip | 73069-6369
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Country | US
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Telephone | 405-310-3262
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 21426-P
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License Number State | OK
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