MEDICARE: ALICE DANTZLER

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	:	1235865536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICE DANTZLER

Provider Business Mailing Address
First Line	:	214 BARBOUR AVE
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-6858
Country	:	US
Telephone Number	:	580-471-2005
Fax Number	:

Provider Business Practice Location Address
First Line	:	1625 GREENBRIAR PL STE 700
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73159-7646
Country	:	US
Telephone Number	:	580-471-2005
Fax Number	:

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

Provider Enumeration Date	:	07/28/2022
Last Update Date	:	07/14/2025

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Directions to “ ALICE DANTZLER ” Practice Location

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