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General NPI Number Information
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NPI Number | 1225450182
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Entity Type | Individual
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Provider Name | ANDREA MILLER LISTER
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Gender | Female
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 5555 S LEWIS AVE
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City | TULSA
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State | OK
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Zip | 74105-7104
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Country | US
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Telephone | 918-779-4556
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Fax |
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Provider Business Mailing Address
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Address Line | 3715 BRANDYWINE DR
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City | METAIRIE
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State | LA
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Zip | 70002-7001
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Country | US
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Telephone | 720-253-6050
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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