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General NPI Number Information
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NPI Number | 1831830447
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Entity Type | Individual
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Provider Name | SAVANNAH DEMORET
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Gender | Female
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 2325 S HARVARD AVE
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City | TULSA
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State | OK
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Zip | 74114-3300
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Country | US
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Telephone | 918-557-4008
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Fax |
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Provider Business Mailing Address
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Address Line | 7106 E 151ST ST S
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City | BIXBY
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State | OK
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Zip | 74008-4137
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Country | US
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Telephone | 918-970-6225
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | T082742298
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License Number State | OK
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