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General NPI Number Information
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NPI Number | 1649623646
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Entity Type | Individual
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Provider Name | SUSAN E OXFORD LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 10/11/2019
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Provider Practice Location Address
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Address Line | 13495 FRANKSTON HIGHWAY
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City | TYLER
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State | TX
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Zip | 75702
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Country | US
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Telephone | 903-231-3620
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 649 BEN WHEELER
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City | BEN WHEELER
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State | TX
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Zip | 75754-0649
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Country | US
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Telephone | 903-714-4761
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Fax | 903-833-2223
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 59144
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License Number State | TX
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