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NPI Code Detail

MEDICARE: TIMOTHY LANE SELLS

MEDICARE: TIMOTHY LANE SELLS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1083046262
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY LANE SELLS
Provider Business Mailing Address
First Line : 2808 NW 31ST ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7407
Country : US
Telephone Number : 405-848-7555
Fax Number :
Provider Business Practice Location Address
First Line : 2808 NW 31ST ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7407
Country : US
Telephone Number : 405-848-7555
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2013
Last Update Date : 07/30/2013

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Directions to “ TIMOTHY LANE SELLS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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