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General NPI Number Information
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NPI Number | 1396186839
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Entity Type | Individual
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Provider Name | AMANDA JANE OSTERDYK LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2013
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1301 NE 14TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-2018
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Country | US
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Telephone | 405-953-1563
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Fax | 918-560-1399
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Provider Business Mailing Address
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Address Line | 650 S PEORIA AVE
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City | TULSA
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State | OK
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Zip | 74120-4429
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Country | US
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Telephone | 918-587-9471
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Fax | 918-560-1399
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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 | 7205
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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