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General NPI Number Information
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NPI Number | 1508515370
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Entity Type | Individual
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Provider Name | CARIN LEA CHADWICK
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Gender | Female
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 320 12TH AVE NE
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City | NORMAN
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State | OK
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Zip | 73071-5238
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Country | US
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Telephone | 405-573-3852
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Fax | 405-366-3870
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Provider Business Mailing Address
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Address Line | 3921 S EAST AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73129-8553
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Country | US
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Telephone | 405-326-9655
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | OK
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