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General NPI Number Information
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NPI Number | 1811059090
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Entity Type | Organization
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Legal Business Name | NANCY MATTER COBB, LCSW, INC
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 717 NW 56TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-6030
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Country | US
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Telephone | 405-415-2305
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Fax |
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Provider Business Mailing Address
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Address Line | 717 NW 56TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-6030
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Country | US
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Telephone | 405-415-2305
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | NANCY MATTER COBB
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Credential | LCSW
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Telephone | 405-415-2305
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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 | 18-CLINICAL
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License Number State | OK
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