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General NPI Number Information
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NPI Number | 1508497827
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Entity Type | Individual
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Provider Name | SAMANTHA FAULKNER
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Gender | Female
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Dates
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Enumeration Date | 01/27/2020
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Last Update Date | 08/13/2020
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Provider Practice Location Address
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Address Line | 1608 S ELWOOD AVE
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City | TULSA
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State | OK
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Zip | 74119-4208
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Country | US
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Telephone | 918-587-3888
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Fax | 918-587-3891
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Provider Business Mailing Address
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Address Line | 623 N 27TH WEST AVE
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City | TULSA
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State | OK
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Zip | 74127-5122
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Country | US
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Telephone | 918-944-3790
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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