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General NPI Number Information
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NPI Number | 1700609336
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Entity Type | Individual
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Provider Name | MS. CHEYANA ELIZABETH HARGROVE COLEMAN
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Gender | Female
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Dates
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Enumeration Date | 11/04/2024
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 9017 N UNIVERSITY AVE APT 10209
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City | OKLAHOMA CITY
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State | OK
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Zip | 73114-4304
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Country | US
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Telephone | 405-248-0288
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 145
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City | BETHANY
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State | OK
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Zip | 73008-0145
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Country | US
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Telephone | 405-248-0288
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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License Number State |
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