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NPI Code Detail

MEDICARE: BRITTANIE JEANE GROESBECK L.C.S.W

MEDICARE: BRITTANIE JEANE GROESBECK L.C.S.W
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
11041C0700XClinical Social Worker2952OK

General Provider Information

NPI Number : 1437297199
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRITTANIE JEANE GROESBECK L.C.S.W
Provider Business Mailing Address
First Line : 1100 NW 14TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-4450
Country : US
Telephone Number : 405-528-7721
Fax Number : 405-609-2880
Provider Business Practice Location Address
First Line : 1100 NW 14TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73106-4450
Country : US
Telephone Number : 405-528-7721
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 03/02/2020

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