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General NPI Number Information
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NPI Number | 1972839819
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Entity Type | Individual
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Provider Name | SUSANNE ADAMS L.P.C.
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Gender | Female
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 10/28/2009
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Provider Practice Location Address
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Address Line | 12005 E. 470 RD. ROGERS COUNTY CLINIC
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City | CLAREMORE
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State | OK
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Zip | 74017-3717
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Country | US
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Telephone | 918-342-0770
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Fax | 918-342-0087
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Provider Business Mailing Address
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Address Line | 114 W. DELAWARE
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City | NOWATA
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State | OK
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Zip | 74048-2601
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Country | US
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Telephone | 918-273-1841
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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 | 4249LPC
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License Number State | OK
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