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NPI Code Detail

MEDICARE: ALLIE MCINTOSH

MEDICARE: ALLIE MCINTOSH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1073925707
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLIE MCINTOSH
Provider Business Mailing Address
First Line : 12721 COBBLESTONE PKWY
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2207
Country : US
Telephone Number : 405-206-1819
Fax Number :
Provider Business Practice Location Address
First Line : 12721 COBBLESTONE PKWY
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-2207
Country : US
Telephone Number : 405-206-1819
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2014
Last Update Date : 05/29/2014

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Directions to “ ALLIE MCINTOSH ” Practice Location

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