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NPI Code Detail

MEDICARE: QUANTONA AMADO MS, MHA, MLS, LPC

MEDICARE:   QUANTONA  AMADO  MS, MHA, MLS, LPC
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) CounselorOK
2101YM0800XMental Health Counselor06974OK

General Provider Information

NPI Number : 1295261402
Entity Type Code : Individual
Provider Name (Legal Business Name) : QUANTONA AMADO MS, MHA, MLS, LPC
Provider Business Mailing Address
First Line : PO BOX 580700
Second Line :
City : TULSA
State : OK
Zip : 74158-0700
Country : US
Telephone Number : 918-430-0975
Fax Number :
Provider Business Practice Location Address
First Line : 1219 N SANTA FE AVE
Second Line :
City : TULSA
State : OK
Zip : 74127-5333
Country : US
Telephone Number : 405-355-8408
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2017
Last Update Date : 09/14/2024

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Directions to “ QUANTONA AMADO MS, MHA, MLS, LPC” Practice Location

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