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General NPI Number Information
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NPI Number | 1477969384
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Entity Type | Individual
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Provider Name | DORA WALKER MENSAH LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/11/2014
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 2700 NE 63RD ST RM 124
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City | OKLAHOMA CITY
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State | OK
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Zip | 73111-8305
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Country | US
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Telephone | 405-633-4653
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Fax |
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Provider Business Mailing Address
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Address Line | 2700 NE 63RD ST RM 124
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City | OKLAHOMA CITY
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State | OK
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Zip | 73111-8305
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Country | US
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Telephone | 405-633-4653
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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 | 5908
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License Number State | OK
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