MEDICARE: ROBERT SEAN WINDERS BFA

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
1	101Y00000X	Counselor

General Provider Information

NPI Number	:	1194836452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT SEAN WINDERS BFA

Provider Business Mailing Address
First Line	:	3312 N VIRGINIA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-3025
Country	:	US
Telephone Number	:	405-722-7408
Fax Number	:

Provider Business Practice Location Address
First Line	:	3312 N VIRGINIA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73118-3025
Country	:	US
Telephone Number	:	405-722-7408
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/07/2009

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