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NPI 1649480781

NPI 1649480781 : GENA M ORR LCSW : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1649480781
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    Entity Type          |    Individual 
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    Provider Name        |    GENA M ORR LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    05/23/2007
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    Last Update Date     |    02/09/2022
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Provider Practice Location Address
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    Address Line         |    3712 E 11TH ST 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74112-3952
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    Country              |    US
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    Telephone            |    918-348-4302
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    Fax                  |    918-834-4189
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Provider Business Mailing Address
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    Address Line         |    3712 E 11TH ST 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74112-3952
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    Country              |    US
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    Telephone            |    918-348-4302
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    Fax                  |    918-834-4189
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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       |    3411
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    License Number State |    OK
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