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General NPI Number Information
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NPI Number | 1578634036
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Entity Type | Individual
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Provider Name | MARY EILEEN CAMERIS LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5525 E. 51ST SUITE 215
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City | TULSA
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State | OK
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Zip | 74135-7818
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Country | US
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Telephone | 918-488-8454
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Fax | 918-488-8118
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Provider Business Mailing Address
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Address Line | 7774 S CANTON AVE
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City | TULSA
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State | OK
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Zip | 74136-8261
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Country | US
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Telephone | 918-488-8454
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Fax | 918-488-8118
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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 | 2399
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License Number State | OK
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