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NPI Code Detail

MEDICARE: MRS. ROCHELLE FAILS

MEDICARE: MRS. ROCHELLE FAILS
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1194072504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ROCHELLE FAILS
Provider Business Mailing Address
First Line : 9421 APPLE DR
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73130-7186
Country : US
Telephone Number : 405-822-6923
Fax Number :
Provider Business Practice Location Address
First Line : 3 E MAIN ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73104-2405
Country : US
Telephone Number : 405-418-3871
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2012
Last Update Date : 08/06/2012

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Directions to “ MRS. ROCHELLE FAILS ” Practice Location

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