MEDICARE: LOIS MARIE FELDER MSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1386059343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOIS MARIE FELDER MSW

Provider Business Mailing Address
First Line	:	5700 N EVEREST AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73111-6732
Country	:	US
Telephone Number	:	405-424-5708
Fax Number	:	405-840-5086

Provider Business Practice Location Address
First Line	:	5700 N EVEREST AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73111-6732
Country	:	US
Telephone Number	:	405-424-5708
Fax Number	:	405-840-5086

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

Provider Enumeration Date	:	06/27/2014
Last Update Date	:	06/27/2014

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