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NPI Code Detail

MEDICARE: LEO LAMBERT INYANG REHAB SPECIALIST

MEDICARE:   LEO LAMBERT INYANG  REHAB SPECIALIST
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 : 1245557214
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEO LAMBERT INYANG REHAB SPECIALIST
Provider Business Mailing Address
First Line : 5714 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-4515
Country : US
Telephone Number : 405-601-1154
Fax Number : 405-601-1183
Provider Business Practice Location Address
First Line : 5714 S WESTERN AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73109-4515
Country : US
Telephone Number : 405-601-1154
Fax Number : 405-601-1183
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2010
Last Update Date : 04/29/2010

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Directions to “ LEO LAMBERT INYANG REHAB SPECIALIST” Practice Location

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